Thoracic Revised Cardiac Risk Index Is Associated With Prognosis After Resection for Stage I Lung Cancer Journal Article

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Authors: Brunelli, A.; Ferguson, M. K.; Salati, M.; Vigneswaran, W. T.; Jimenez, M. F.; Varela, G.
Article Title: Thoracic Revised Cardiac Risk Index Is Associated With Prognosis After Resection for Stage I Lung Cancer
Abstract: BACKGROUND: The objective of this investigation is to evaluate whether the Thoracic Revised Cardiac Risk Index (ThRCRI) is an independent prognostic factor after lung resection for early-stage lung cancer. METHODS: Observational analysis performed on 1,370 patients (from 2000 to 2011) undergoing anatomic lung resection for pathologic stage I non-small cell lung cancer in three thoracic surgery units. Survival was calculated by the Kaplan-Meier method. The association between survival and several clinical variables was determined by Cox multivariate analysis. RESULTS: Median follow-up was 77 months. Patients were assigned to risk classes according to their ThRCRI score: class A (score, 0 to 1), 1,062 patients; class B (score, 1.5 to 2.5), 284 patients; class C (score, >2.5), 24 patients. Patients in class A had a longer 5-year overall survival (66%) compared w those in classes B (53%) and C (35%; log-rank test, p 0.0001). The ThRCRI remained an independent prognostic factor after Cox regression analysis (hazard ratio, 1.2; p = 0.001) along with age (hazard ratio, 1.03; p 0.0001), pT stage (hazard ratio, 1.6; p 0.0001), and forced expiratory volume in 1 second (hazard ratio, 0.98; p 0.0001). Five-year cancer-specific survival was longer in patients with ThRCRI class A (77%) compared with classes B (75%) and C (55%; log-rank test, p = 0.05). Mortality from cardiac events occurring during follow-up was 1.5% in class A, 7% in class B, and 13% in class C (p 0.0001). CONCLUSIONS: The ThRCRI is a useful prognostic score in patients undergoing resection for early-stage lung cancer. Patients with a score greater than 2.5 should be counseled about their increased risk of major perioperative cardiac events and their expected decreased long-term survival.
Journal Title: The Annals of Thoracic Surgery
Volume: 100
Issue: 1
ISSN: 1552-6259; 0003-4975
Publisher: Unknown  
Journal Place: Netherlands
Date Published: 2015
Start Page: 195
End Page: 200
Language: eng
DOI/URL:

10.1016/j.athoracsur.2015.03.103
Notes: CI: Copyright (c) 2015; JID: 15030100R; CIN: Ann Thorac Surg. 2015 Jul;100(1):200. PMID: 26140764; 2015/01/17 [received]; 2015/03/14 [revised]; 2015/03/18 [accepted]; 2015/05/21 [aheadofprint]; ppublish