Outcome after surgery for lung cancer

This study is a secondary analysis of data collected under the ethically approved project titled: The financial burden of complications associated with surgical lung resection: a retrospective audit. In this study we will be observing the number of patients that have had a textbook outcome after lung resection surgery for non-small cell lung cancer (NSCLC) between 1 January 2011 and 31st December 2023. The concept of a composite metric known as the textbook outcome has emerged as a patient-centred quality measure, Textbook outcome integrates multiple clinical and perioperative outcomes into a single, readily interpretable indicator capturing the ideal postoperative scenario. Our definition of a textbook outcome for NSCLC resection are the following: 1. Negative resection margins, confirmed through microscopy 2. Complete lymph node dissection (LND), defined with expert input from thoracic surgeons, and in accordance with guidelines published by the International Association for the Study of Lung Cancer. This includes a minimum of six lymph node stations assessed: at least three from the mediastinum, including the subcarinal node (station 7), and three from the hilar and intrapulmonary stations or laterality-specific inclusion of stations, which are 2R, 4R, 7, 10R, and 11R for right-sided tumours, and 5, 6, 7, 10 L, and 11 L for left-sided tumours 3. No mortality within 30 days of the index operation 4. No reintervention within 30 days of the index operation (video-assisted thoracoscopic surgery, thoracotomy, bronchoscopy, or percutaneous drainage) 5. No prolonged stay or readmission to the ICU or HDU after discharge to general wards 6. No prolonged hospital stay (greater or equal to 14 days) 7. No hospital readmission after hospital discharge 8. No major complications during the index stay, excluding those accounted for by screening for reinterventions within 30 days, with major complications defined as Clavien-Dindo class III or greater15: a. III: complications requiring surgical, endoscopic, or radiological intervention b. III-a: class III interventions without general anaesthesia c. III-b: class III interventions under general anaesthesia d. IV: life-threatening complications requiring admission to the ICU e. IV-a: single-organ dysfunction, including dialysis f. IV-b: multiorgan dysfunction g. V: death As this is a retrospective study, there is no participant involvement. Only the de-identified hospital medical record of NSCLC adult patients who have undergone lung resection will be reviewed.