1. Spanish Lung Cancer Group SCAT trial: surgical audit to lymph node assessment based on IASLC recommendations
- Author
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Marcelo F. Jiménez, Antonio Pablo Gámez García, Sergio Bolufer Nadal, José Ramón Jarabo Sarceda, Juan Carlos Peñalver Cuesta, Ramón Moreno Balsalobre, Bartomeu Massuti, E. Pereira, Pedro Castro, Florentino Hernando Trancho, Joaquín Pac Ferrer, Jesús Gabriel Sales-Badía, Mariano Provencio, Raúl Embún Flor, Roberto Mongil Poce, Francisco Javier Algar Algar, [Jarabo Sarceda, Jose Ramon] Hosp Clin San Carlos, Dept Thorac Surg, Madrid, Spain, [Hernando Trancho, Florentino] Hosp Clin San Carlos, Dept Thorac Surg, Madrid, Spain, [Bolufer Nadal, Sergio] Hosp Univ Alicante, Dept Thorac Surg, Alicante, Spain, [Mongil Poce, Roberto] Hosp Univ Malaga, Dept Thorac Surg, Malaga, Spain, [Lopez de Castro, Pedro] Hosp Badalona Germans Trias & Pujol, Dept Thorac Surg, Barcelona, Spain, [Moreno Balsalobre, Ramon] Hosp Univ Princesa, Dept Thorac Surg, Madrid, Spain, [Penalver Cuesta, Juan Carlos] Inst Valenciano Oncol, Dept Thorac Surg, Valencia, Spain, [Embun Flor, Raul] Hosp Univ Miguel Servet, Dept Thorac Surg, IIS Aragon, Zaragoza, Spain, [Pac Ferrer, Joaquin] Hosp Univ Cruces, Dept Thorac Surg, Bilbao, Spain, [Algar Algar, Francisco Javier] Hosp Univ Reina Sofia Cordoba, Dept Thorac Surg, Cordoba, Spain, [Gamez Garcia, Antonio Pablo] Hosp Univ 12 Octubre, Dept Thorac Surg, Madrid, Spain, [Jimenez, Marcelo F.] Hosp Univ Salamanca, Dept Thorac Surg, Salamanca, Spain, [Gabriel Sales-Badia, Jesus] Hosp Univ Fe, Dept Thorac Surg, Valencia, Spain, [Pereira, Eva] Spanish Lung Canc Grp, Barcelona, Spain, [Massuti, Bartomeu] Hosp Univ Alicante, Dept Med Oncol, Alicante, Spain, [Provencio, Mariano] Hosp Univ Puerta Hierro Majadahonda, Dept Oncol, Madrid, Spain, and Sanofi-Aventis
- Subjects
medicine.medical_specialty ,Non-small cell lung cancer (NSCLC), lymph node dissection (LND), surgery, survival ,Survival ,medicine.medical_treatment ,non-small cell lung cancer (NSCLC) ,Non-small cell lung cancer (NSCLC) ,030204 cardiovascular system & hematology ,surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Adjuvant therapy ,Lung cancer ,Ratio ,Lymph node ,Stage-i ,Pattern ,business.industry ,International association ,Number ,lymph node dissection (LND) ,Resection ,medicine.disease ,Quality ,respiratory tract diseases ,Dissection ,Impact ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Mediastinal lymph node ,Original Article ,Lymphadenectomy ,Radiology ,Lymph ,business ,Prognostic value - Abstract
BACKGROUND: The Spanish Customized Adjuvant Therapy (SCAT) trial assessed the role of individualized adjuvant therapy in clinical N0 incidental pN1 and/or N2 non-small cell lung cancer (NSCLC) completely resected. We assessed surgical topics with an in-depth analysis of quality of lymphadenectomy based on International Association for the Study of Lung Cancer (IASLC) recommendations. METHODS: Patients with information about lymphadenectomy available were included (N=451). Prospectively collected data about tumor, type of resection, and postoperative morbidity and quality of lymph node dissection (LND) were retrospectively evaluated. Role of lymph node assessment on survival was analyzed using Kaplan-Meier curves, using regression models to identify prognostic factors. RESULTS: In 33.7%, 17.7% and 49.9% of cases, regions 7, 10 and 11 respectively were not assessed. In 21.1% of patients, less than three lymph node regions were biopsied, while in 19.6% of patients less than six lymph nodes were assessed. In 53,4% of patients only one N1 region was evaluated. From patients with positive N2, 8.9% had no N1 regions biopsied. Twenty-nine percent of patients with at least one N2 lymph node resected shown the highest region involved. Thirty-day postoperative mortality was unknown. Five-year overall survival (OS) was 61.7% (95% CI: 55.4–67.4%), 51.5% (95% CI: 39.2–62.4%) and 42.3% (95% CI: 32.1–52.2%) for patients with N1, N2 and N1+N2 disease, respectively (P
- Published
- 2021
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