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The Society of Thoracic Surgeons Composite Score Rating for Pulmonary Resection for Lung Cancer.

Publication ,  Journal Article
Broderick, SR; Grau-Sepulveda, M; Kosinski, AS; Kurlansky, PA; Shahian, DM; Jacobs, JP; Becker, S; DeCamp, MM; Seder, CW; Grogan, EL; Brown, LM ...
Published in: Ann Thorac Surg
March 2020

BACKGROUND: The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) has developed composite quality measures for lobectomy and esophagectomy. This study sought to develop a composite measure including all resections for lung cancer. METHODS: The STS lung cancer composite score is based on 2 outcomes: risk-adjusted mortality and morbidity. GTSD data were included from January 2015 to December 2017. "Star ratings" were created for centers with 30 or more cases by using 95% Bayesian credible intervals. The Bayesian model was performed with and without inclusion of the minimally invasive approach to assess the impact of approach on the composite measure. RESULTS: The study population included 38,461 patients from 256 centers. Overall operative mortality was 1.3% (495 of 38,461). The major complication rate was 7.9% (3045 of 38,461). The median number of nodes examined was 10 (interquartile range, 5 to 16); the median number of nodal stations sampled was 4 (interquartile range, 3 to 5). Positive resection margins were identified in 3.7% (1420 of 38,461). A total of 214 centers with 30 or more cases were assigned star ratings. There were 7 1-star, 194 2-star, and 13 3-star programs; 70.6% of resections were performed through a minimally invasive approach. Inclusion of minimally invasive approach, which was adjusted for in previous models, altered the star ratings for 3% (6 of 214) of the programs. CONCLUSIONS: Participants in the STS GTSD perform lung cancer resection with low morbidity and mortality. Lymph node data suggest that participants are meeting contemporary staging standards. There is wide variability among participants in application of minimally invasive approaches. The study found that risk adjustment for approach altered ratings in 3% of participants.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

March 2020

Volume

109

Issue

3

Start / End Page

848 / 855

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery
  • Survival Rate
  • Societies, Medical
  • Respiratory System
  • Reproducibility of Results
  • Postoperative Complications
  • Pneumonectomy
  • Outcome Assessment, Health Care
  • Neoplasm Staging
 

Citation

APA
Chicago
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Broderick, S. R., Grau-Sepulveda, M., Kosinski, A. S., Kurlansky, P. A., Shahian, D. M., Jacobs, J. P., … Kozower, B. D. (2020). The Society of Thoracic Surgeons Composite Score Rating for Pulmonary Resection for Lung Cancer. Ann Thorac Surg, 109(3), 848–855. https://doi.org/10.1016/j.athoracsur.2019.08.114
Broderick, Stephen R., Maria Grau-Sepulveda, Andrzej S. Kosinski, Paul A. Kurlansky, David M. Shahian, Jeffrey P. Jacobs, Susan Becker, et al. “The Society of Thoracic Surgeons Composite Score Rating for Pulmonary Resection for Lung Cancer.Ann Thorac Surg 109, no. 3 (March 2020): 848–55. https://doi.org/10.1016/j.athoracsur.2019.08.114.
Broderick SR, Grau-Sepulveda M, Kosinski AS, Kurlansky PA, Shahian DM, Jacobs JP, et al. The Society of Thoracic Surgeons Composite Score Rating for Pulmonary Resection for Lung Cancer. Ann Thorac Surg. 2020 Mar;109(3):848–55.
Broderick, Stephen R., et al. “The Society of Thoracic Surgeons Composite Score Rating for Pulmonary Resection for Lung Cancer.Ann Thorac Surg, vol. 109, no. 3, Mar. 2020, pp. 848–55. Pubmed, doi:10.1016/j.athoracsur.2019.08.114.
Broderick SR, Grau-Sepulveda M, Kosinski AS, Kurlansky PA, Shahian DM, Jacobs JP, Becker S, DeCamp MM, Seder CW, Grogan EL, Brown LM, Burfeind W, Magee M, Raymond DP, Puri V, Chang AC, Kozower BD. The Society of Thoracic Surgeons Composite Score Rating for Pulmonary Resection for Lung Cancer. Ann Thorac Surg. 2020 Mar;109(3):848–855.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

March 2020

Volume

109

Issue

3

Start / End Page

848 / 855

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery
  • Survival Rate
  • Societies, Medical
  • Respiratory System
  • Reproducibility of Results
  • Postoperative Complications
  • Pneumonectomy
  • Outcome Assessment, Health Care
  • Neoplasm Staging