Surgeon experience influence lymphadenectomy during VATS lobectomy : National VATS database results
© 2024 Published by Elsevier Ltd..
OBJECTIVES: Aim of this study is to identify the factors that may influence the lymphadenectomy during VATS anatomical lung resection with particular interest on operator experience.
MATERIALS AND METHODS: Clinical and pathological data from the prospective VATS Italian nationwide registry were reviewed and analysed. Patients with incomplete data regarding tumor and surgical characteristics, GGO, or with distant metastases were excluded. Patients clinical data, tumor characteristics, operation information and surgeon experience were collected and compared to resected lymph nodes number (#RN), resected N2 nodes number (#N2RN) and resected N2 stations number. A multivariable model was built using logistic regression analysis. Surgeon experience was categorized considering the number of VATS major anatomical resection and years after residency.
RESULTS: The final analysis was conducted on 3727 patients. The median #RN and #N2RN were 11 (1-51) and 5 (0-41). Regarding the analysed outcomes, #N2RN > 6 resulted in 1812 (48.8%)cases, #RN > 10 in 2124 (57.0%)cases and more than 3 N2 stations were harvested in 1447 (38.8%)patients. First operator experience with number of VATS lobectomies>50 (p < 0.001), operator seniority after residency5-10years (p < 0.001), cTNM II/III(p = 0.017), lobectomy/bilobectomy vs segmentectomy (p < 0.001), and upper/middle lobe tumor location (p < 0.005)resulted significantly associated to #N2RN > 6 at the multivariable analysis. First operator experience with number of VATS lobectomies>50 (p < 0.001), operator seniority after residency5-10years (p < 0.001) and lobectomy/bilobectomy (p < 0.001) resulted significantly associated to #RN > 10 at the multivariable analysis.
CONCLUSIONS: Our study showed that lymphadenectomy during VATS lobectomy is influenced by tumor factors such as cTstage and tumor location but also by operator experience, with a higher number of resected lymph nodes in surgeons with a high number of VATS procedures and years after residency compared to surgeons with less experience.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology - 50(2024), 4 vom: 26. Apr., Seite 108054 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chiappetta, Marco [VerfasserIn] |
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| Links: |
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Journal Article |
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| Anmerkungen: |
Date Completed 01.04.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejso.2024.108054 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369475941 |
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| 100 | 1 | |a Chiappetta, Marco |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Surgeon experience influence lymphadenectomy during VATS lobectomy |b National VATS database results |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 01.04.2024 | ||
| 500 | |a Date Revised 01.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 Published by Elsevier Ltd. | ||
| 520 | |a OBJECTIVES: Aim of this study is to identify the factors that may influence the lymphadenectomy during VATS anatomical lung resection with particular interest on operator experience | ||
| 520 | |a MATERIALS AND METHODS: Clinical and pathological data from the prospective VATS Italian nationwide registry were reviewed and analysed. Patients with incomplete data regarding tumor and surgical characteristics, GGO, or with distant metastases were excluded. Patients clinical data, tumor characteristics, operation information and surgeon experience were collected and compared to resected lymph nodes number (#RN), resected N2 nodes number (#N2RN) and resected N2 stations number. A multivariable model was built using logistic regression analysis. Surgeon experience was categorized considering the number of VATS major anatomical resection and years after residency | ||
| 520 | |a RESULTS: The final analysis was conducted on 3727 patients. The median #RN and #N2RN were 11 (1-51) and 5 (0-41). Regarding the analysed outcomes, #N2RN > 6 resulted in 1812 (48.8%)cases, #RN > 10 in 2124 (57.0%)cases and more than 3 N2 stations were harvested in 1447 (38.8%)patients. First operator experience with number of VATS lobectomies>50 (p < 0.001), operator seniority after residency5-10years (p < 0.001), cTNM II/III(p = 0.017), lobectomy/bilobectomy vs segmentectomy (p < 0.001), and upper/middle lobe tumor location (p < 0.005)resulted significantly associated to #N2RN > 6 at the multivariable analysis. First operator experience with number of VATS lobectomies>50 (p < 0.001), operator seniority after residency5-10years (p < 0.001) and lobectomy/bilobectomy (p < 0.001) resulted significantly associated to #RN > 10 at the multivariable analysis | ||
| 520 | |a CONCLUSIONS: Our study showed that lymphadenectomy during VATS lobectomy is influenced by tumor factors such as cTstage and tumor location but also by operator experience, with a higher number of resected lymph nodes in surgeons with a high number of VATS procedures and years after residency compared to surgeons with less experience | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Lymph nodes | |
| 650 | 4 | |a Non small cell lung cancer | |
| 650 | 4 | |a Surgeon | |
| 650 | 4 | |a Surgery | |
| 650 | 4 | |a VATS | |
| 700 | 1 | |a Sassorossi, Carolina |e verfasserin |4 aut | |
| 700 | 1 | |a Lococo, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Curcio, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Crisci, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Sperduti, Isabella |e verfasserin |4 aut | |
| 700 | 1 | |a Meacci, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a Margaritora, Stefano |e verfasserin |4 aut | |
| 700 | 0 | |a VATS Group Italy |e verfasserin |4 aut | |
| 700 | 1 | |a Maurizio, Mancuso |e investigator |4 oth | |
| 700 | 1 | |a Fausto, Pernazza |e investigator |4 oth | |
| 700 | 1 | |a Majed, Refai |e investigator |4 oth | |
| 700 | 1 | |a Franco, Stella |e investigator |4 oth | |
| 700 | 1 | |a Desideria, Argnani |e investigator |4 oth | |
| 700 | 1 | |a Giuseppe, Marulli |e investigator |4 oth | |
| 700 | 1 | |a Angela, De Palma |e investigator |4 oth | |
| 700 | 1 | |a Luigi, Bortolotti |e investigator |4 oth | |
| 700 | 1 | |a Giovanna, Rizzardi |e investigator |4 oth | |
| 700 | 1 | |a Piergiorgio, Solli |e investigator |4 oth | |
| 700 | 1 | |a Giampiero, Dolci |e investigator |4 oth | |
| 700 | 1 | |a Reinhold, Perkmann |e investigator |4 oth | |
| 700 | 1 | |a Francesco, Zaraca |e investigator |4 oth | |
| 700 | 1 | |a Roberto, Benvenuti Mauro |e investigator |4 oth | |
| 700 | 1 | |a Diego, Gavezzoli |e investigator |4 oth | |
| 700 | 1 | |a Roberto, Cherchi |e investigator |4 oth | |
| 700 | 1 | |a Albino, Ferrari Paolo |e investigator |4 oth | |
| 700 | 1 | |a Felice, Mucilli |e investigator |4 oth | |
| 700 | 1 | |a Pierpaolo, Camplese |e investigator |4 oth | |
| 700 | 1 | |a Giulio, Melloni |e investigator |4 oth | |
| 700 | 1 | |a Federico, Mazza |e investigator |4 oth | |
| 700 | 1 | |a Giorgio, Cavallesco |e investigator |4 oth | |
| 700 | 1 | |a Pio, Maniscalco |e investigator |4 oth | |
| 700 | 1 | |a Luca, Voltolini |e investigator |4 oth | |
| 700 | 1 | |a Alessandro, Gonfiotti |e investigator |4 oth | |
| 700 | 1 | |a Francesco, Sollitto |e investigator |4 oth | |
| 700 | 1 | |a Pia, Ardò Nicoletta |e investigator |4 oth | |
| 700 | 1 | |a Luca, Pariscenti Gian |e investigator |4 oth | |
| 700 | 1 | |a Carlo, Risso |e investigator |4 oth | |
| 700 | 1 | |a Corrado, Surrente |e investigator |4 oth | |
| 700 | 1 | |a Camillo, Lopez |e investigator |4 oth | |
| 700 | 1 | |a Andrea, Droghetti |e investigator |4 oth | |
| 700 | 1 | |a Michele, Giovanardi |e investigator |4 oth | |
| 700 | 1 | |a Cristiano, Breda |e investigator |4 oth | |
| 700 | 1 | |a Fabio, Lo Giudice |e investigator |4 oth | |
| 700 | 1 | |a Marco, Alloisio |e investigator |4 oth | |
| 700 | 1 | |a Edoardo, Bottoni |e investigator |4 oth | |
| 700 | 1 | |a Lorenzo, Spaggiari |e investigator |4 oth | |
| 700 | 1 | |a Roberto, Gasparri |e investigator |4 oth | |
| 700 | 1 | |a Massimo, Torre |e investigator |4 oth | |
| 700 | 1 | |a Alessandro, Rinaldo |e investigator |4 oth | |
| 700 | 1 | |a Mario, Nosotti |e investigator |4 oth | |
| 700 | 1 | |a Davide, Tosi |e investigator |4 oth | |
| 700 | 1 | |a Giampeiro, Negri |e investigator |4 oth | |
| 700 | 1 | |a Alessandro, Bandiera |e investigator |4 oth | |
| 700 | 1 | |a Alessandro, Baisi |e investigator |4 oth | |
| 700 | 1 | |a Federico, Raveglia |e investigator |4 oth | |
| 700 | 1 | |a Alessandro, Stefani |e investigator |4 oth | |
| 700 | 1 | |a Pamela, Natali |e investigator |4 oth | |
| 700 | 1 | |a Marco, Scarci |e investigator |4 oth | |
| 700 | 1 | |a Emanuele, Pirondini |e investigator |4 oth | |
| 700 | 1 | |a Carlo, Curcio |e investigator |4 oth | |
| 700 | 1 | |a Dario, Amore |e investigator |4 oth | |
| 700 | 1 | |a Ottavio, Rena |e investigator |4 oth | |
| 700 | 1 | |a Samuele, Nicotra |e investigator |4 oth | |
| 700 | 1 | |a Andrea, Dell' Amore |e investigator |4 oth | |
| 700 | 1 | |a Alessandro, Bertani |e investigator |4 oth | |
| 700 | 1 | |a Giorgia, Tancredi |e investigator |4 oth | |
| 700 | 1 | |a Luca, Ampollini |e investigator |4 oth | |
| 700 | 1 | |a Paolo, Carbognani |e investigator |4 oth | |
| 700 | 1 | |a Francesco, Puma |e investigator |4 oth | |
| 700 | 1 | |a Damiano, Vinci |e investigator |4 oth | |
| 700 | 1 | |a Giuseppe, Cardillo |e investigator |4 oth | |
| 700 | 1 | |a Francesco, Carleo |e investigator |4 oth | |
| 700 | 1 | |a Nachira, Dania |e investigator |4 oth | |
| 700 | 1 | |a Piero, Paladini |e investigator |4 oth | |
| 700 | 1 | |a Marco, Ghisalberti |e investigator |4 oth | |
| 700 | 1 | |a Roberto, Crisci |e investigator |4 oth | |
| 700 | 1 | |a Duilio, Divisi |e investigator |4 oth | |
| 700 | 1 | |a Diego, Fontana |e investigator |4 oth | |
| 700 | 1 | |a Vittorio, Della Beffa |e investigator |4 oth | |
| 700 | 1 | |a Angelo, Morelli |e investigator |4 oth | |
| 700 | 1 | |a Francesco, Londero |e investigator |4 oth | |
| 700 | 1 | |a Andrea, Imperatori |e investigator |4 oth | |
| 700 | 1 | |a Nicola, Rotolo |e investigator |4 oth | |
| 700 | 1 | |a Alberto |e investigator |4 oth | |
| 700 | 1 | |a Andrea, Viti |e investigator |4 oth | |
| 700 | 1 | |a Maurizio, Infante |e investigator |4 oth | |
| 700 | 1 | |a Cristiano, Benato |e investigator |4 oth | |
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