Skip to main content
Top
Published in: Surgical Endoscopy 7/2021

01-07-2021 | NSCLC

Naples Prognostic Score as a novel prognostic prediction tool in video-assisted thoracoscopic surgery for early-stage lung cancer: a propensity score matching study

Authors: Shuangjiang Li, Hongyu Wang, Zhang Yang, Liang Zhao, Wenyu Lv, Heng Du, Guowei Che, Lunxu Liu

Published in: Surgical Endoscopy | Issue 7/2021

Login to get access

Abstract

Backgrounds

The Naples Prognostic Score (NPS) emerges as a novel prognostic scoring system in surgical oncology. We aim to assess the prognostic significance of preoperative NPS in patients undergoing completely video-assisted thoracoscopic surgery (VATS) lobectomy for early-stage non-small cell lung cancer (NSCLC) by propensity score matching (PSM) analysis.

Methods

The present study was conducted on our single-center prospectively maintained database between January 2014 and December 2015. A Kaplan–Meier survival analysis using the log-rank test was used to distinguish differences in both overall survival (OS) and disease-free survival (DFS) between the patients stratified by preoperative NPS. Finally, multivariable Cox-proportional hazards regression analysis and PSM analysis were carried out to determine the independent prognostic factors for both OS and DFS.

Results

There were 457 patients with operable primary stage I–II NSCLC included. Per 1-point increase in NPS was found to be significantly associated with unfavorable OS and DFS of NSCLC. Both OS and DFS were significantly shortened along with each number increase in the NPS group, showing a step-wise fashion. Such strong correlations between preoperative NPS and survival outcomes still remained validated after PSM analysis. In addition, NPS held the best discriminatory power for predicting both OS and DFS when compared to the other peripheral biomarkers. Multivariable analyses on the entire cohort and the PSM cohort demonstrated that preoperative NPS could be an independent prognostic indicator for both OS and DFS.

Conclusions

The NPS scoring system can serve as a novel risk stratification tool to refine prognostic prediction after VATS lobectomy for surgically resected NSCLC.
Literature
1.
go back to reference Goldstraw P, Chansky K, Crowley J et al (2016) The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 11(1):39–51CrossRef Goldstraw P, Chansky K, Crowley J et al (2016) The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 11(1):39–51CrossRef
2.
go back to reference Wu CF, de la Mercedes T, Fernandez R et al (2019) Management of intra-operative major bleeding during single-port video-assisted thoracoscopic anatomic resection: two-center experience. Surg Endosc 33(6):1880–1889CrossRef Wu CF, de la Mercedes T, Fernandez R et al (2019) Management of intra-operative major bleeding during single-port video-assisted thoracoscopic anatomic resection: two-center experience. Surg Endosc 33(6):1880–1889CrossRef
3.
go back to reference Jensen K, Petersen RH, Hansen HJ, Walker W, Pedersen JH, Konge L (2018) A novel assessment tool for evaluating competence in video-assisted thoracoscopic surgery lobectomy. Surg Endosc 32(10):4173–4182CrossRef Jensen K, Petersen RH, Hansen HJ, Walker W, Pedersen JH, Konge L (2018) A novel assessment tool for evaluating competence in video-assisted thoracoscopic surgery lobectomy. Surg Endosc 32(10):4173–4182CrossRef
4.
go back to reference Jensen K, Hansen HJ, Petersen RH et al (2019) Evaluating competency in video-assisted thoracoscopic surgery (VATS) lobectomy performance using a novel assessment tool and virtual reality simulation. Surg Endosc 33(5):1465–1473CrossRef Jensen K, Hansen HJ, Petersen RH et al (2019) Evaluating competency in video-assisted thoracoscopic surgery (VATS) lobectomy performance using a novel assessment tool and virtual reality simulation. Surg Endosc 33(5):1465–1473CrossRef
6.
go back to reference Li SJ, Lv WY, Du H et al (2019) Albumin-to-alkaline phosphatase ratio as a novel prognostic indicator for patients undergoing minimally invasive lung cancer surgery: propensity score matching analysis using a prospective database. Int J Surg 69:32–42CrossRef Li SJ, Lv WY, Du H et al (2019) Albumin-to-alkaline phosphatase ratio as a novel prognostic indicator for patients undergoing minimally invasive lung cancer surgery: propensity score matching analysis using a prospective database. Int J Surg 69:32–42CrossRef
7.
go back to reference Li S, Yang Z, Du H, Zhang W, Che G, Liu L (2019) Novel systemic inflammation response index to predict prognosis after thoracoscopic lung cancer surgery: a propensity score-matching study. ANZ J Surg 89(11):E507–E513CrossRef Li S, Yang Z, Du H, Zhang W, Che G, Liu L (2019) Novel systemic inflammation response index to predict prognosis after thoracoscopic lung cancer surgery: a propensity score-matching study. ANZ J Surg 89(11):E507–E513CrossRef
8.
go back to reference Hirahara N, Tajima Y, Fujii Y et al (2019) Controlling Nutritional Status (CONUT) as a prognostic immunonutritional biomarker for gastric cancer after curative gastrectomy: a propensity score-matched analysis. Surg Endosc 33(12):4143–4152CrossRef Hirahara N, Tajima Y, Fujii Y et al (2019) Controlling Nutritional Status (CONUT) as a prognostic immunonutritional biomarker for gastric cancer after curative gastrectomy: a propensity score-matched analysis. Surg Endosc 33(12):4143–4152CrossRef
9.
go back to reference Iwasaki Y, Ishizuka M, Takagi K et al (2019) A high preoperative Glasgow prognostic score predicts a high likelihood of conversion from laparoscopic to open surgery in patients with colon cancer. Surg Endosc 33(4):1111–1116CrossRef Iwasaki Y, Ishizuka M, Takagi K et al (2019) A high preoperative Glasgow prognostic score predicts a high likelihood of conversion from laparoscopic to open surgery in patients with colon cancer. Surg Endosc 33(4):1111–1116CrossRef
10.
go back to reference Galizia G, Lieto E, Auricchio A et al (2017) Naples Prognostic Score, based on nutritional and inflammatory status, is an independent predictor of long-term outcome in patients undergoing surgery for colorectal cancer. Dis Colon Rectum 60(12):1273–1284CrossRef Galizia G, Lieto E, Auricchio A et al (2017) Naples Prognostic Score, based on nutritional and inflammatory status, is an independent predictor of long-term outcome in patients undergoing surgery for colorectal cancer. Dis Colon Rectum 60(12):1273–1284CrossRef
11.
go back to reference Miyamoto Y, Hiyoshi Y, Daitoku N et al (2019) Naples Prognostic Score is a useful prognostic marker in patients with metastatic colorectal cancer. Dis Colon Rectum 62(12):1485–1493CrossRef Miyamoto Y, Hiyoshi Y, Daitoku N et al (2019) Naples Prognostic Score is a useful prognostic marker in patients with metastatic colorectal cancer. Dis Colon Rectum 62(12):1485–1493CrossRef
12.
go back to reference Nakagawa N, Yamada S, Sonohara F et al (2019) Clinical implications of Naples Prognostic Score in patients with resected pancreatic cancer. Ann Surg Oncol 27(3):887–895CrossRef Nakagawa N, Yamada S, Sonohara F et al (2019) Clinical implications of Naples Prognostic Score in patients with resected pancreatic cancer. Ann Surg Oncol 27(3):887–895CrossRef
13.
go back to reference Yang Q, Chen T, Yao Z, Zhang X (2020) Prognostic value of pre-treatment Naples Prognostic Score (NPS) in patients with osteosarcoma. World J Surg Oncol 18(1):24CrossRef Yang Q, Chen T, Yao Z, Zhang X (2020) Prognostic value of pre-treatment Naples Prognostic Score (NPS) in patients with osteosarcoma. World J Surg Oncol 18(1):24CrossRef
14.
go back to reference Agha R, Abdall-Razak A, Crossley E et al (2019) STROCSS 2019 Guideline: strengthening the reporting of cohort studies in surgery. Int J Surg 72:156–165CrossRef Agha R, Abdall-Razak A, Crossley E et al (2019) STROCSS 2019 Guideline: strengthening the reporting of cohort studies in surgery. Int J Surg 72:156–165CrossRef
15.
go back to reference Mei J, Guo C, Xia L et al (2019) Long-term survival outcomes of video-assisted thoracic surgery lobectomy for stage I-II non-small cell lung cancer are more favorable than thoracotomy: a propensity score-matched analysis from a high-volume center in China. Transl Lung Cancer Res 8(2):155–166CrossRef Mei J, Guo C, Xia L et al (2019) Long-term survival outcomes of video-assisted thoracic surgery lobectomy for stage I-II non-small cell lung cancer are more favorable than thoracotomy: a propensity score-matched analysis from a high-volume center in China. Transl Lung Cancer Res 8(2):155–166CrossRef
16.
go back to reference Li S, Zhou K, Lai Y et al (2018) Estimated intraoperative blood loss correlates with postoperative cardiopulmonary complications and length of stay in patients undergoing video-assisted thoracoscopic lung cancer lobectomy: a retrospective cohort study. BMC Surg 18(1):29CrossRef Li S, Zhou K, Lai Y et al (2018) Estimated intraoperative blood loss correlates with postoperative cardiopulmonary complications and length of stay in patients undergoing video-assisted thoracoscopic lung cancer lobectomy: a retrospective cohort study. BMC Surg 18(1):29CrossRef
17.
go back to reference Yang Z, Li S, Zhao L et al (2020) Serum uric acid to lymphocyte ratio: a novel prognostic biomarker for surgically resected early-stage lung cancer. A propensity score matching analysis. Clin Chim Acta 503:35–44CrossRef Yang Z, Li S, Zhao L et al (2020) Serum uric acid to lymphocyte ratio: a novel prognostic biomarker for surgically resected early-stage lung cancer. A propensity score matching analysis. Clin Chim Acta 503:35–44CrossRef
18.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRef Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRef
19.
go back to reference Fernandez FG, Falcoz PE, Kozower BD, Salati M, Wright CD, Brunelli A (2015) The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons general thoracic surgery databases: joint standardization of variable definitions and terminology. Ann Thorac Surg 99(1):368–376CrossRef Fernandez FG, Falcoz PE, Kozower BD, Salati M, Wright CD, Brunelli A (2015) The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons general thoracic surgery databases: joint standardization of variable definitions and terminology. Ann Thorac Surg 99(1):368–376CrossRef
20.
go back to reference Li S, Zhou K, Wang M, Lin R, Fan J, Che G (2018) Degree of pulmonary fissure completeness can predict postoperative cardiopulmonary complications and length of hospital stay in patients undergoing video-assisted thoracoscopic lobectomy for early-stage lung cancer. Interact Cardiovasc Thorac Surg 26(1):25–33CrossRef Li S, Zhou K, Wang M, Lin R, Fan J, Che G (2018) Degree of pulmonary fissure completeness can predict postoperative cardiopulmonary complications and length of hospital stay in patients undergoing video-assisted thoracoscopic lobectomy for early-stage lung cancer. Interact Cardiovasc Thorac Surg 26(1):25–33CrossRef
21.
go back to reference Kim HJ, Seo JH, Park KU, Kim YT, Park IK, Bahk JH (2019) Effect of combining a recruitment maneuver with protective ventilation on inflammatory responses in video-assisted thoracoscopic lobectomy: a randomized controlled trial. Surg Endosc 33(5):1403–1411CrossRef Kim HJ, Seo JH, Park KU, Kim YT, Park IK, Bahk JH (2019) Effect of combining a recruitment maneuver with protective ventilation on inflammatory responses in video-assisted thoracoscopic lobectomy: a randomized controlled trial. Surg Endosc 33(5):1403–1411CrossRef
22.
go back to reference Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature 454(7203):436–444CrossRef Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature 454(7203):436–444CrossRef
23.
go back to reference Liang W, Ferrara N (2016) The complex role of neutrophils in tumor angiogenesis and metastasis. Cancer Immunol Res 4:83–91CrossRef Liang W, Ferrara N (2016) The complex role of neutrophils in tumor angiogenesis and metastasis. Cancer Immunol Res 4:83–91CrossRef
24.
go back to reference Qian BZ, Pollard JW (2010) Macrophage diversity enhances tumor progression and metastasis. Cell 141(1):39–51CrossRef Qian BZ, Pollard JW (2010) Macrophage diversity enhances tumor progression and metastasis. Cell 141(1):39–51CrossRef
25.
go back to reference McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 12(3):223–226CrossRef McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 12(3):223–226CrossRef
26.
go back to reference Zhang G, Zhang D, Wu J et al (2018) Low serum levels of pre-surgical total cholesterol are associated with unfavorable overall survival in patients with operable non-small cell lung cancer. Clin Lab 64(3):321–327PubMed Zhang G, Zhang D, Wu J et al (2018) Low serum levels of pre-surgical total cholesterol are associated with unfavorable overall survival in patients with operable non-small cell lung cancer. Clin Lab 64(3):321–327PubMed
Metadata
Title
Naples Prognostic Score as a novel prognostic prediction tool in video-assisted thoracoscopic surgery for early-stage lung cancer: a propensity score matching study
Authors
Shuangjiang Li
Hongyu Wang
Zhang Yang
Liang Zhao
Wenyu Lv
Heng Du
Guowei Che
Lunxu Liu
Publication date
01-07-2021
Publisher
Springer US
Keywords
NSCLC
NSCLC
Published in
Surgical Endoscopy / Issue 7/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07851-7

Other articles of this Issue 7/2021

Surgical Endoscopy 7/2021 Go to the issue