The number of lymph nodes examined is associated with survival outcomes and nodal upstaging in patients with stage I small cell lung cancer

2020 ◽  
Author(s):  
Yan Chen ◽  
Jing Zhang ◽  
Cong Jiang ◽  
Han Zhang ◽  
Pengyu Fan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage I ◽  
Survival Outcomes ◽  
Small Cell Lung ◽  
Nodal Upstaging

scholarly journals Nodal Upstaging Evaluation After Robotic-Assisted Lobectomy for Early-Stage Non-small Cell Lung Cancer Compared to Video-Assisted Thoracic Surgery and Thoracotomy: A Retrospective Single Center Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Filippo Tommaso Gallina ◽  
Enrico Melis ◽  
Daniele Forcella ◽  
Edoardo Mercadante ◽  
Daniele Marinelli ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Robotic Surgery ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Radical Lymphadenectomy ◽  
Nodal Upstaging

Introduction: The standard surgical procedures for patients with early-stage NSCLC is lobectomy-associated radical lymphadenectomy performed by using the thoracotomy approach. In the last few years, minimally invasive techniques have increasingly strengthened their role in lung cancer treatment, especially in the early stage of the disease. Although the lobectomy technique has been accepted, controversy still surrounds lymph node dissection. In our study, we analyze the rate of upstaging early non-small cell lung cancer patients who underwent radical surgical treatment using the robotic and the VATS techniques compared to the standard thoracotomy approach.Methods and Materials: We retrospectively reviewed patients who underwent a lobectomy and radical lymphadenectomy at our Institute between 2010 and 2019. We selected 505 patients who met the inclusion criteria of the study: 237 patients underwent robotic surgery, 158 patients had thoracotomy, and 110 patients were treated with VATS. We analyzed the demographic features between the groups as well as the nodal upstaging rate after pathological examination, the number of dissected lymph nodes and the ratio of dissected lymph nodes to metastatic lymph nodes of the three groups.Results: The patients of the three groups were homogenous with respect to age, sex, and histology. The postoperative major morbidity rate was significantly higher in the thoracotomy group, and hospital stay was significantly longer. The percentage of the mediastinal nodal upstaging rate and the number of dissected lymph nodes was significantly higher in the robotic group compared with the VATS group. The ratio of dissected lymph nodes to metastatic lymph nodes was significantly lower compared with the VATS group and the thoracotomy group.Discussion: The prognostic impact of the R(un) status is still highly debated. A surgical approach that allows better results in terms of resection has still not been defined. Our results show that robotic surgery is a safe and feasible approach especially regarding the accuracy of mediastinal lymphadenectomy. These findings can lead to defining a more precise pathological stage of the disease and, if necessary, to more accurate postoperative treatment.

scholarly journals Survival outcomes of lobectomy in comparison with segmentectomy in clinical stage I non-small-cell lung cancer: a meta-analysis

2019 ◽  
Author(s):  
Jian Feng ◽  
Yan-Yue Han ◽  
Yue Wang ◽  
Xiu-Yu Wu ◽  
Feng Lv ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Literature Search ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Small Cell ◽  
Stage I ◽  
Survival Outcomes ◽  
Small Cell Lung

Abstract Background: The gold standard surgical therapy for patients with Clinical stage I non-small-cell lung cancer (NSCLC) is lobectomy with mediastinal lymph node dissection. While, segmentectomy has emerged as an alternative choice with the advantage of fewer postoperative complications. While the acceptance of this procedure still remains controversial, and conflicting results exist in the retrospective trials. Objectives: The aim of this meta-analysis was to analysis the survival outcomes of Lobectomy in comparison with segmentectomy in treatment of Clinical stage I non-small-cell lung cancer. Methods: Computerized literature search was done on the published trials in Pubmed, Embase, Cochrane library databases to June, 2019 to identify clinical trials. Lung cancer-specific survival (LCSS) and overall survival (OS) were measured as outcomes. Statistical analysis was performed in the Meta-analysis Revman 5.3 software. Results: A systematic literature search was conducted including 7 studies. In this meta-analysis, results indicate that lobectomy confers an equivalent survival outcome compared with segmentectomy. Conclusion: No significant differences were found in survival outcomes between lobectomy and segmentectomy. Further prospective large-scale, prospective, randomized trials are needed to explore the reasonable surgical treatment for early resectable lung cancer.

scholarly journals Relationship between early recurrence and micrometastases in the lymph nodes of patients with stage I non-small-cell lung cancer

1997 ◽  
Vol 114 (4) ◽  
pp. 535-543 ◽  
Author(s):  
Riichiroh Maruyama ◽  
Kenji Sugio ◽  
Tetsuya Mitsudomi ◽  
Genkichi Saitoh ◽  
Teruyoshi Ishida ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Recurrence ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung

scholarly journals Survival Outcomes of Lobectomy in Comparison With Segmentectomy in Clinical Stage I Non-small-cell Lung Cancer: a Meta-analysis

2021 ◽  
Author(s):  
Jian Feng ◽  
Yan-Yue Han ◽  
Yue Wang ◽  
Xiu-Yu Wu ◽  
Feng Lv ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Literature Search ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Small Cell ◽  
Stage I ◽  
Survival Outcomes ◽  
Small Cell Lung

Abstract Background: The gold standard surgical therapy for patients with clinical stage I non-small-cell lung cancer (NSCLC) is lobectomy with mediastinal lymph node dissection. While, segmentectomy has emerged as an alternative choice with the advantage of fewer postoperative complications. However, the acceptance of this procedure still remains controversial, and conflicting results exist in the retrospective trials.Objectives: The aim of this meta-analysis was to analysis the survival outcomes of lobectomy in comparison with segmentectomy in treatment of clinical stage I non-small-cell lung cancer. Methods: Computerized literature search was done on the published trials in Pubmed, Embase, Cochrane library databases to June, 2019 to identify clinical trials. Lung cancer-specific survival (LCSS) and overall survival (OS) were measured as outcomes. Statistical analysis was performed using the Meta-analysis Revman 5.3 software.Results: A systematic literature search was conducted including 7 studies. In this meta-analysis, results indicate that lobectomy confers an equivalent survival outcome compared with segmentectomy. Conclusion: No significant differences were found in survival outcomes between lobectomy and segmentectomy. Further prospective large-scale, prospective, randomized trials are needed to explore the reasonable surgical treatment for early resectable lung cancer.

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