Applicability and validation of a Clavien-Dindo classification for postoperative complications in lung cancer surgery

This is the authors' abstract. We don't add key points for this paper.

Background: There is no standard scale to evaluate complications after lung cancer surgery. Many surgical fields use the Clavien-Dindo classification for postoperative complications. We adapted the Clavien–Dindo classification by modifying it to reflect the complications that developed in patients who underwent surgery for lung cancer at our clinic. We aimed to demonstrate the applicability and accuracy of this classification. Methods: A retrospective study involving 802 patients who underwent lung cancer surgery at two sites was conducted between January 2002 and December 2019. Age, gender, surgical method, procedure, complications, and survival times were documented. One hundred eighty patients who experienced complications were assessed using the Clavien-Dindo classification. The correlation between this grading and survival was examined. Results: Of 802 patients who underwent surgery for lung cancer, 180 patients developed 224 complications. The distribution of complications according to the Clavien-Dindo classification was as follows: Grade I: 46 patients (25.6%); Grade II: 64 patients (35.6%); Grade IIIa: 22 patients (12.2%); Grade IIIb: 12 patients (6.7%); Grade IVa: 10 patients (5.6%); Grade IVb: 10 patients (5.6%); Grade V: 16 patients (8.9%). In the survival analysis, survival decreased significantly with increasing Clavien-Dindo complication grade (p < 0.001). Conclusion: There is no standardized classification of complications after lung cancer resection. We found the Clavien-Dindo classification to be applicable and verifiable for analyzing complications after lung cancer surgery. The effect of the Clavien-Dindo classification on survival underscores the importance of classifying complications after lung cancer surgery. To clarify this important issue, a database should be created, and large-scale multicenter studies should be conducted.