Table 2. Development of the VALCAN-O Score.
| Variablea | aHR (95% CI) | β | P value | VALCAN-O points |
|---|---|---|---|---|
| Delayed surgery | ||||
| >12 wk | 1 [Reference] | 0 | ||
| ≤12 wk | 0.89 (0.84 to 0.94) | −0.12 | <.001 | 1 |
| Surgical approach | ||||
| Open | 1 [Reference] | 0 | ||
| Minimally invasive | 0.92 (0.87 to 0.97) | −0.09 | .003 | 1 |
| Extent of resection | ||||
| Wedge | 1 [Reference] | 0 | ||
| Lobectomy | 0.83 (0.77 to 0.89) | −0.19 | <.001 | 2 |
| Segmentectomy | 0.82 (0.72 to 0.94) | −0.19 | .004 | 2 |
| Pneumonectomyb | 1.08 (0.88 to 1.34) | 0.08 | .47 | 0 |
| Nodal sampling adequacy, LNs | ||||
| 0 | 1 [Reference] | 0 | ||
| 1-4 | 0.88 (0.89 to 0.96) | −0.13 | .008 | 1 |
| 5-9 | 0.82 (0.74 to 0.90) | −0.20 | <.001 | 2 |
| ≥10 | 0.78 (0.70 to 0.86) | −0.25 | <.001 | 3 |
| Surgical marginc | ||||
| R1+ | 1 [Reference] | 0 | ||
| R0 | 0.58 (0.51 to 0.67) | −0.54 | <.001 | 6 |
Abbreviations: aHR, adjusted hazard ratio; LNs, lymph nodes; VALCAN-O, Veterans Affairs Lung Cancer Operative quality.
a
Model controlling for displayed covariates in addition to age, sex, race, body mass index, smoking status, Charlson Comorbidity Index score, number of unique prescriptions, hospital volume, location of tumor, histology, pathologic stage, and tumor size. The full model is available in eTable 1 in the Supplement.
b
Pneumonectomy was given a score of 0 to prevent negative scores in the model.
c
For the surgical margin, R0 indicates negative margin and R1+ indicates positive margin.