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Comparative Study
. 2021 Mar;161(3):776-786.
doi: 10.1016/j.jtcvs.2020.06.151. Epub 2020 Aug 24.

Eurolung risk score is associated with long-term survival after curative resection for lung cancer

Alessandro Brunelli  1 , Nilanjan Chaudhuri  2 , Manos Kefaloyannis  2 , Richard Milton  2 , Cecilia Pompili  2 , Peter Tcherveniakov  2 , Kostas Papagiannopoulos  2
Affiliations
Comparative Study

Eurolung risk score is associated with long-term survival after curative resection for lung cancer

Alessandro Brunelli et al. J Thorac Cardiovasc Surg. 2021 Mar.

Abstract

Objective: The study objective was to verify whether the Eurolung score was associated with long-term prognosis after lung cancer resection.

Methods: A total of 1359 consecutive patients undergoing anatomic lung resection (1136 lobectomies, 103 pneumonectomies, 120 segmentectomies) (2014-2018) were analyzed. The parsimonious aggregate Eurolung2 score was calculated for each patient. Median follow-up was 802 days. Survival distribution was estimated by the Kaplan-Meier method. Cox proportional hazard regression and competing risk regression analyses were used to assess the independent association of Eurolung with overall and disease-specific survival.

Results: Patients were grouped into 4 classes according to their Eurolung scores (A 0-2.5, B 3-5, C 5.5-6.5, D 7-11.5). Most patients were in class A (52%) and B (33%), 8% were in class C, and 7% were in class D. Five-year overall survival decreased across the categories (A: 75%; B: 52%; C: 29%; D: 27%, log rank P < .0001). The score stratified the 3-year overall survival in patients with pT1 (P < .0001) or pT>1 (P < .0001). In addition, the different classes were associated with incremental risk of long-term overall mortality in patients with pN0 (P < .0001) and positive nodes (P = .0005). Cox proportional hazard regression and competing regression analyses showed that Eurolung aggregate score remained significantly associated with overall (hazard ratio, 1.19; P < .0001) and disease-specific survival after adjusting for pT and pN stage (hazard ratio, 1.09; P = .005).

Conclusions: Eurolung aggregate score was associated with long-term survival after curative resection for cancer. This information may be valuable to inform the shared decision-making process and the multidisciplinary team discussion assisting in the selection of the most appropriate curative treatment in high-risk patients.

Keywords: Eurolung; lung cancer; risk model; risk stratification; surgery; survival.

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Figures

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Graphical abstract
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Kaplan–Meier comparison of OS between different Eurolung classes of risk in patients with lung cancer after lung resection. Higher Eurolung risk categories are associated with worse prognosis (log rank test P < .0001).
Figure 1
Figure 1
Kaplan–Meier OS estimates after lung cancer resection stratified by Eurolung classes of risk. Shaded areas represent 95% CIs. Higher Eurolung risk categories are associated with worse prognosis (log-rank test P < .0001).
Figure 2
Figure 2
Kaplan–Meier OS estimates after lung cancer resection stratified by Eurolung risk classes showing a worse survival in higher Eurolung classes of risk either in patients with pT 1 stage, P < .0001 (A) and in those with pT greater than 1 stage, P < .0001 (B). Shaded areas represent 95% CIs.
Figure 3
Figure 3
Kaplan–Meier OS estimates after lung cancer resection stratified by Eurolung risk classes showing a worse survival in higher Eurolung classes of risk either in patients with pN0 stage, P < .0001 (A) and in those with pN positive stage, P = .0005 (B). Shaded areas represent 95% CIs.
Figure 4
Figure 4
Cumulative incidence of lung cancer–specific death in patients with different Eurolung classes of risk. Competing regression analysis was used to adjust for pT and pN stage where the competing events were deaths for other cancers and for causes other than cancer.
Figure 5
Figure 5
Summarizing the analyzed population and main findings of the analysis. NSCLC, Non--small cell lung cancer.
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Comment in

References

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