The association of nodal upstaging with surgical approach and its impact on long-term survival after resection of non-small-cell lung cancer

Abstract OBJECTIVES Proponents of open thoracotomy (OPEN) and robot-assisted thoracic surgery (RATS) claim its oncological superiority over video-assisted thoracic surgery (VATS) in terms of the accuracy of lymph node staging. METHODS The National Cancer Database was queried for patients with non-sm...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2020-05, Vol.57 (5), p.888-895
Main Authors: Hennon, Mark W, DeGraaff, Luke H, Groman, Adrienne, Demmy, Todd L, Yendamuri, Sai
Format: Article
Language:English
Subjects:
Thoracic
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Summary:Abstract OBJECTIVES Proponents of open thoracotomy (OPEN) and robot-assisted thoracic surgery (RATS) claim its oncological superiority over video-assisted thoracic surgery (VATS) in terms of the accuracy of lymph node staging. METHODS The National Cancer Database was queried for patients with non-small-cell lung cancer (NSCLC) undergoing lobectomy without neoadjuvant therapy from 2010 to 2014. Nodal upstaging rates were compared using a surgical approach. Overall survival adjusted for confounding variables was examined using the Cox proportional hazards model. RESULTS A total of 64 676 patients fulfilled the selection criteria. The number of patients who underwent lobectomy by RATS, VATS and OPEN approaches was 5470 (8.5%), 17 545 (27.1%) and 41 661 (64.4%), respectively. The mean number of lymph nodes examined for each of these approaches was 10.9, 11.3 and 10 (P 
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezz320