Upstaging and survival after robotic-assisted thoracoscopic lobectomy for non-small cell lung cancer
| Autor: | Frank O. Velez-Cubian, Carla Moodie, J. Glover, Joseph Garrett, Kavian Toosi, Emily Ng, Jacques P. Fontaine, Eric M. Toloza |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Lung Neoplasms Kaplan-Meier Estimate 030204 cardiovascular system & hematology Risk Assessment Cohort Studies 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Carcinoma Non-Small-Cell Lung medicine Carcinoma Adjuvant therapy Humans Neoplasm Invasiveness Hospital Mortality Registries Stage (cooking) Lung cancer Pneumonectomy Survival rate Lymph node Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Thoracic Surgery Video-Assisted Middle Aged medicine.disease Surgery Survival Rate medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Mediastinal lymph node Lymph Node Excision Female Lymph Lymph Nodes business Follow-Up Studies |
| Zdroj: | Surgery. 160(5) |
| ISSN: | 1532-7361 |
| Popis: | Background Mediastinal involvement in resected non-small-cell lung cancer mandates adjuvant therapy and affects survival. This study investigated lymph node dissection efficacy, lymph node metastasis detection, and survival after robotic-assisted lobectomy for non-small-cell lung cancer. Methods We retrospectively analyzed patients who underwent robotic-assisted lobectomy for non-small-cell lung cancer. Survival was assessed through chart reviews, Social Security Death Registry, and national obituary searches. Kaplan-Meier survival curves by clinical and pathologic stage were compared by log-rank and Cox regression analysis. Results In 249 patients (mean age, 67.8 ± 0.6 years), mean individual mediastinal lymph nodes retrieved was 7.7 ± 0.3 lymph nodes, with mean of 13.9 ± 0.4 N1+ mediastinal lymph nodes. There were 159 (63.9%) clinical stage I versus 134 (53.8%) pathologic stage I patients, with 67 (26.9%) patients upstaged (20 cN0 to pN1; 17 cN0 to pN2; 4 cN1 to pN2) and 37 (14.9%) downstaged. One-year and 3-year survival rates, respectively, changed between clinical stage I (clinical stage I, 91% and 70%; clinical stage II, 80% and 64%; clinical stage III, 78% and 57%; clinical stage IV, 71% and 45%) and pathologic stage (pathologic stage I, 92% and 75%; clinical stage II, 83% and 73%; pathologic stage III, 75% and 44%; and pathologic stage IV, 67% and 0%). Conclusion Mediastinal lymph node dissection during robotic-assisted lobectomy adequately assesses lymph node stations and detects occult lymph node metastasis. Stage-specific survival is affected by upstaging. |
| Databáze: | OpenAIRE |
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