Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data

被引:2
作者
Gabryel, Piotr [1 ]
Roszak, Magdalena [2 ]
Skrzypczak, Piotr [1 ]
Gabryel, Anna [1 ]
Zielinska, Dominika [1 ]
Sielewicz, Magdalena [1 ]
Campisi, Alessio [3 ]
Kasprzyk, Mariusz [1 ]
Piwkowski, Cezary [1 ]
机构
[1] Poznan Univ Med Sci, Dept Thorac Surg, Szamarzewskiego 62 St, PL-60569 Poznan, Poland
[2] Poznan Univ Med Sci, Dept Comp Sci & Stat, Rokietnicka 7 St, PL-60806 Poznan, Poland
[3] Univ & Hosp Trust, Osped Borgo Trento, Dept Thorac Surg, Piazzale Aristide Stefani 1, I-37126 Verona, Italy
关键词
lung cancer; surgery; lobe-specific; lymphadenectomy; minimally invasive surgery; lobectomy; thoracoscopy/VATS; LigaSure; energy device; GENDER-DIFFERENCES; THORACIC SURGEONS; LYMPH-NODES; SURVIVAL; RESECTION; MONOPOLAR; DIATHERMY; OUTCOMES; SOCIETY; IMPACT;
D O I
10.3390/jcm12113780
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The outcomes of non-small cell lung cancer surgery are influenced by the quality of lymphadenectomy. This study aimed to evaluate the impact of different energy devices on lymphadenectomy quality and identify additional influencing factors. This secondary analysis of the prospective randomized trial data (clinicaltrials.gov: NCT03125798) compared patients who underwent thoracoscopic lobectomy with the LigaSure device (study group, n = 96) and monopolar device (control group, n = 94). The primary endpoint was the lobe-specific mediastinal lymphadenectomy. Lobe-specific mediastinal lymphadenectomy criteria were met in 60.4% and 38.3% of patients in the study and control groups, respectively (p = 0.002). In addition, in the study group, the median number of mediastinal lymph node stations removed was higher (4 vs. 3, p = 0.017), and complete resection was more often achieved (91.7% vs. 80.9%, p = 0.030). Logistic regression analysis indicated that lymphadenectomy quality was positively associated with the use of the LigaSure device (OR, 2.729; 95% CI, 1.446 to 5.152; p = 0.002) and female sex (OR, 2.012; 95% CI, 1.058 to 3.829; p = 0.033), but negatively associated with a higher Charlson Comorbidity Index (OR, 0.781; 95% CI, 0.620 to 0.986; p = 0.037), left lower lobectomy (OR, 0.263; 95% CI, 0.096 to 0.726; p = 0.010) and middle lobectomy (OR, 0.136; 95% CI, 0.031 to 0.606, p = 0.009). This study found that using the LigaSure device can improve the quality of lymphadenectomy in lung cancer patients and also identified other factors that affect the quality of lymphadenectomy. These findings contribute to improving lung cancer surgical treatment outcomes and provide valuable insights for clinical practice.
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页数:13
相关论文
共 32 条
[1]   Node Doubt: Rigorous Surgical Nodal Procurement Combined With Thorough Pathologic Evaluation Improves Non-Small Cell Lung Carcinoma Staging Accuracy [J].
Butnor, Kelly J. ;
Asamura, Hisao ;
Travis, William D. .
ANNALS OF THORACIC SURGERY, 2016, 102 (02) :353-356
[2]   Impact of the Extent of Lymph Node Dissection on Precise Staging and Survival in Clinical I-II Pure-Solid Lung Cancer Undergoing Lobectomy [J].
Chen, Donglai ;
Mao, Yiming ;
Wen, Junmiao ;
Shu, Jian ;
Ye, Fei ;
She, Yunlang ;
Ding, Qifeng ;
Shi, Li ;
Xue, Tao ;
Fan, Min ;
Chen, Yongbing ;
Chen, Chang .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2021, 19 (04) :393-+
[3]   Sex and Gender Differences in Non-Small Cell Lung Cancer [J].
Donington, Jessica S. ;
Colson, Yolonda L. .
SEMINARS IN THORACIC AND CARDIOVASCULAR SURGERY, 2011, 23 (02) :137-145
[4]   Comparison of lateral thermal damage of the human peritoneum using monopolar diathermy, Harmonic scalpel and LigaSure [J].
Druzijanic, Nikica ;
Pogorelic, Zenon ;
Perko, Zdravko ;
Mrklic, Ivana ;
Tomic, Snjezana .
CANADIAN JOURNAL OF SURGERY, 2012, 55 (05) :317-321
[5]   Adequacy of Intraoperative Nodal Staging during Surgical Resection of NSCLC: Influencing Factors and Its Relationship to Survival [J].
Edwards, Tim ;
Balata, Haval ;
Elshafi, Mohamed ;
Foden, Philip ;
Bishop, Paul ;
Fontaine, Eustace ;
Jones, Mark ;
Krysiak, Piotr ;
Rammohan, Kandadai ;
Shah, Rajesh ;
Crosbie, Philip ;
Booton, Richard ;
Evison, Matthew .
JOURNAL OF THORACIC ONCOLOGY, 2017, 12 (12) :1845-1850
[6]  
Ferlay J, 2022, Global Cancer Observatory: Cancer Today. LyonaLyon, Fr Int Agency Res Cancer
[7]   The Society of Thoracic Surgeons and The European Society of Thoracic Surgeons General Thoracic Surgery Databases: Joint Standardization of Variable Definitions and Terminology [J].
Fernandez, Felix G. ;
Falcoz, Pierre E. ;
Kozower, Benjamin D. ;
Salati, Michele ;
Wright, Cameron D. ;
Brunelli, Alessandro .
ANNALS OF THORACIC SURGERY, 2015, 99 (01) :368-376
[8]   Comparison of the LigaSure™ bipolar vessel sealer to monopolar electrocoagulation for thoracoscopic lobectomy and lymphadenectomy: a prospective randomized controlled trial [J].
Gabryel, Piotr ;
Kasprzyk, Mariusz ;
Roszak, Magdalena ;
Campisi, Alessio ;
Smolinski, Szymon ;
Zielinski, Pawel ;
Piwkowski, Cezary .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2023, 37 (06) :4449-4457
[9]   Lymphadenectomy in the subcarinal zone using a uniportal thoracoscopic approach: a narrative review [J].
Homma, Takahiro ;
Shimada, Yoshifumi ;
Tanabe, Keitaro .
AME SURGICAL JOURNAL, 2022, 2
[10]   Advances and safe use of energy devices in lung cancer surgery [J].
Homma, Takahiro .
GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 2022, 70 (03) :207-218