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.
引用
收藏
页数:13
相关论文
共 32 条
[21]   Assessment of adequacy of intraoperative nodal staging and factors influencing the lack of its compliance with recommendations in the surgical treatment of non-small cell lung cancer (NSCLC) [J].
Pawelczyk, Konrad ;
Blasiak, Piotr ;
Szromek, Monika ;
Nowinska, Katarzyna ;
Marciniak, Marek .
JOURNAL OF THORACIC DISEASE, 2018, 10 (08) :4902-4911
[22]   The evolving landscape of sex-based differences in lung cancer: a distinct disease in women [J].
Ragavan, Meera ;
Patel, Manali, I .
EUROPEAN RESPIRATORY REVIEW, 2022, 31 (163)
[23]  
Rami-Porta R, 2016, Staging Manual in Thoracic Oncology, V2nd
[24]   The Evolving Concept of Complete Resection in Lung Cancer Surgery [J].
Rami-Porta, Ramon .
CANCERS, 2021, 13 (11)
[25]   Rationale for a Minimum Number of Lymph Nodes Removed with Non-Small Cell Lung Cancer Resection: Correlating the Number of Nodes Removed with Survival in 98,970 Patients [J].
Samayoa, Andres X. ;
Pezzi, Todd A. ;
Pezzi, Christopher M. ;
Gay, E. Greer ;
Asai, Megumi ;
Kulkarni, Nandini ;
Carp, Ned ;
Chun, Stephen G. ;
Putnam, Joe B., Jr. .
ANNALS OF SURGICAL ONCOLOGY, 2016, 23 :S1005-S1011
[26]   Optimal treatment strategies for stage I non-small cell lung cancer in veterans with pulmonary and cardiac comorbidities [J].
Sigel, Keith ;
Kong, Chung Yin ;
Rehmani, Sadiq ;
Bates, Susan ;
Gould, Michael ;
Stone, Kimberly ;
Kale, Minal ;
Park, Yeun-Hee ;
Crothers, Kristina ;
Bhora, Faiz ;
Wisnivesky, Juan .
PLOS ONE, 2021, 16 (03)
[27]   Comparison of lateral thermal spread using monopolar and bipolar diathermy, the Harmonic Scalpel™ and the Ligasure™ [J].
Sutton, P. A. ;
Awad, S. ;
Perkins, A. C. ;
Lobo, D. N. .
BRITISH JOURNAL OF SURGERY, 2010, 97 (03) :428-433
[28]   Lung cancer [J].
Thai, Alesha A. ;
Solomon, Benjamin J. ;
Sequist, Lecia, V ;
Gainor, Justin F. ;
Heist, Rebecca S. .
LANCET, 2021, 398 (10299) :535-554
[29]   Sex differences in early outcomes after lung cancer resection: Analysis of the Society of Thoracic Surgeons General Thoracic Database [J].
Tong, Betty C. ;
Kosinski, Andrzej S. ;
Burfeind, William R., Jr. ;
Onaitis, Mark W. ;
Berry, Mark F. ;
Harpole, David H., Jr. ;
D'Amico, Thomas A. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2014, 148 (01) :13-18
[30]   The 2015 World Health Organization Classification of Lung Tumors Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification [J].
Travis, William D. ;
Brambilla, Elisabeth ;
Nicholson, Andrew G. ;
Yatabe, Yasushi ;
Austin, John H. M. ;
Beasley, Mary Beth ;
Chirieac, Lucian. R. ;
Dacic, Sanja ;
Duhig, Edwina ;
Flieder, Douglas B. ;
Geisinger, Kim ;
Hirsch, Fred R. ;
Ishikawa, Yuichi ;
Kerr, Keith M. ;
Noguchi, Masayuki ;
Pelosi, Giuseppe ;
Powell, Charles A. ;
Tsao, Ming Sound ;
Wistuba, Ignacio .
JOURNAL OF THORACIC ONCOLOGY, 2015, 10 (09) :1243-1260