New Thoracic Surgery Risk Calculators Support Preoperative Decision-Making

The Society of Thoracic Surgeons (STS, Chicago, IL, USA) has introduced two new risk calculators to assist physician-patient decision-making in thoracic surgery. Developed using contemporary data from the STS General Thoracic Surgery Database, these interactive tools provide surgeons with precise preoperative risk estimates for outcomes of esophagectomy for cancer and pulmonary resection for lung cancer. Designed to be mobile-friendly, the risk calculators enable surgeons and multidisciplinary medical providers to assess a patient’s individual risk in real time, considering specific factors such as tumor characteristics, comorbidities, and the procedures performed. As users input patient factors, the risk estimates for morbidity and mortality are dynamically calculated along with 95% confidence intervals. The aim is to equip thoracic surgeons with simple, intuitive resources that support preoperative decision-making and enhance the quality of care.

The new esophagectomy for cancer risk calculator is driven by improved STS esophagectomy risk models, utilizing data from 18,503 patients across 254 hospitals from January 2015 to December 2022. This patient cohort is four times larger than those used in previous models, leading to more accurate estimates and wider applicability. Significant updates include the addition of new risk factors, such as preoperative cancer staging and body surface area. Similarly, the pulmonary resection for lung cancer risk calculator is based on updated STS risk models derived from data on 140,927 patients at 337 hospitals from 2015 to 2022. This model captures current trends and techniques in thoracic surgery, including the increasing use of minimally invasive and robot-assisted procedures.

These new thoracic surgery risk calculators are part of an ongoing series of enhancements to the STS National Database, aimed at addressing the everyday needs of surgeons, data managers, and cardiothoracic care teams. Additional risk calculators focusing on long-term outcomes are expected to be released in 2025. The STS National Database is one of the largest and most comprehensive clinical registries, encompassing nearly 10 million cardiothoracic procedures performed by over 4,300 surgeons. These new online tools are included in a suite of risk calculators designed for adult cardiac and thoracic surgery.

“The esophagectomy for cancer risk calculator represents a significant advancement in personalized care for thoracic surgery patients,” said STS President Jennifer C. Romano, MD, MS. “Informed by a more diverse patient cohort, and using preoperative variables, the tool provides surgeons and patients with a comprehensive and informed view of predicted outcomes. The new risk calculator for pulmonary resection of lung cancer offers superior performance and applicability, especially for high-risk patients. It serves as a valuable tool for both clinical decision-making and improving patient outcomes.”

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