Prognostic Factors of Complications After Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer-A Retrospective Study

Abstract Background: Video-assisted thoracoscopic surgery, safe and minimally invasive, is the first strategy recommended for non-small cell lung cancer. The purpose of this study was to determine the risk factors for postoperative cardiopulmonary complications (including cardiac and pulmonary complications) in patients with NSCLC who underwent video-assisted thoracoscopic surgery (VATS).Methods: We retrospectively collected information of 3142 lung cancer patients undergoing VATS tumor resection at Jiangsu Provincial People's Hospital from January 2017 to June 2018, and established a clinical prediction model using the factors selected by univariate analysis.Results: A total of 305 in 3142 patients developed postoperative cardiopulmonary complications. In univariate analysis, age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, albumin before surgery, pre-albumin, Δalbumin and pleura adhesion were all associated with cardiac and pulmonary complications. Multivariate analysis showed that age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, pre-albumin, Δalbumin were important independent risk factors for complications. Finally, age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, Δalbumin variables were included in the model (AUC=0.743).Conclusion: Nutritional status (PNI, pre-albumin), CCI, age, long-term smoking history before surgery, conversion to thoracotomy were all independent risk factors for postoperative complications and poor prognosis. Experienced surgeons should instruct the operation of high-risk patients to avoid long-term hospitalization and possible poor prognosis after surgery.