Nodal Upstaging Is More Common with Thoracotomy than with VATS During Lobectomy for Early-Stage Lung Cancer: An Analysis from the National Cancer Data Base

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
Rachel L MedberyFelix Fernandez

Abstract

Questions remain regarding differences in nodal evaluation and upstaging between thoracotomy (open) and video-assisted thoracic surgery (VATS) approaches to lobectomy for early-stage lung cancer. Potential differences in nodal staging based on operative approach remain the final significant barrier to widespread adoption of VATS lobectomy. The current study examines differences in nodal staging between open and VATS lobectomy. The National Cancer Data Base was queried for patients with clinical stage T2N0M0 or lower lung cancer who underwent lobectomy in 2010-2011. Propensity score matching was performed to compare the rate of nodal upstaging in VATS with that in open approaches. Additional subgroup analysis was performed to assess whether rates of upstaging differed by specific clinical setting. A total of 16,983 lobectomies were analyzed; 4935 (29.1%) were performed using VATS. Nodal upstaging was more frequent in the open group (12.8% versus 10.3%; p < 0.001). In 4437 matched pairs, nodal upstaging remained more common for open approaches. For a subgroup of patients who had seven lymph or more nodes examined, propensity matching revealed that nodal upstaging remained more common after an open approach than after VATS (14.0% ...Continue Reading

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Citations

Jun 25, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Herbert DecaluwéThomas D'Amico
Jun 25, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Rachel L Medbery, Felix G Fernandez
Jul 28, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Florian KocherFlorian Augustin
Jul 28, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Rachel L Medbery, Felix G Fernandez
Sep 7, 2016·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Fernando Vannucci, Diego Gonzalez-Rivas
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