Lymph node evaluation by open or video-assisted approaches in 11,500 anatomic lung cancer resections.

摘要: Background Unsuspected lymph node metastases are found in the surgical specimens of 10% to 25% clinical stage I lung cancers. Video-assisted thoracic surgery (VATS) is a minimally invasive alternative thoracotomy. Because detection clinically occult dependent on completeness dissection, influence approach nodal evaluation interest. We determined frequency identified node-negative tumors by thoracotomy ("open") and VATS approaches approximate dissections. Methods The Society Thoracic Surgery database was queried for lobectomies segmentectomies from 2001 2010. Results A total 11,531 (7,137 open 4,394 VATS) primary cancers were resected. Nodal upstaging seen 14.3% (1,024) group 11.6% (508) ( p = 0.52). Among 2,745 propensity-matched pairs, N0 N1 remained less common with (6.8% versus 9%; 0.002). Conclusions During lobectomy or segmentectomy cancer, mediastinal results equivalent upstaging. In contrast, lower rates may indicate variability peribronchial hilar evaluation. Systematic dissection encouraged, particularly as more surgeons adopt approach.