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• W2569598826 abstract "Several studies reported a lower rate of nodal upstaging in patients undergoing Video-assisted-thoracoscopic-surgery (VATS) anatomic resections compared to patients treated with an open resection. Aim of this analysis was to investigate nodal upstaging in cases treated by VATS or an open approach and to delineate predictive factors in a large consecutive cohort of patients. NSCLC patients with cN0 status treated between 2004 and 2015 were included in this retrospective analysis. Tumors were reevaluated with regards to tumor location: a tumor was classified “central”, if it had contact to the main bronchus or first segmental branch in a CT scan or was visible during bronchoscopy. All others were classified “peripheral.” VATS was introduced in 2009, since that time all clinically nodal negative patients were treated with an intended VATS approach. Surgery was performed in 370 cN0 patients: 257 (69.5%) VATS and 113 (30.5%) open resections. 49 lesions (13.2%) were classified as central tumors. Nodal upstaging was detected in 73 (19.7%) patients. The rate of upstaging was 19.1% and 21.2% in VATS and open resection, respectively (p=0.629). There was significantly more upstaging in centrally located tumors with thoracotomy (33.3% vs. 10.3%, p=0.045). No difference was found in peripherally located tumors (18.5% vs. 20.2%, p=0.73). cT stage was significantly higher in thoracotomy patients (p<0.001) and was also associated with a higher rate of upstaging. No difference between VATS and open resection was observed in the different tumor stages (cT1: 14.7% vs. 10.9%, p=0.478; cT2: 30.5% vs. 27.1%, p=0.698; cT3: 28.6% vs. 50, p=0.285). However, there was a trend towards larger tumorsize in centrally located tumors with thoracotomy (p=0.062). According to our analysis VATS is not associated with reduced rates of nodal upstaging. cT status was a predictive factor for nodal upstaging. The higher rate of nodal upstaging in centrally located tumors with open resection might be biased by a larger tumor size." @default.
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• W2569598826 date "2017-01-01" @default.
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• W2569598826 title "P3.04-019 Nodal Upstaging in cN0 Lung Cancer is More Influenced by Tumor Size Than the Surgical Approach" @default.
• W2569598826 doi "https://doi.org/10.1016/j.jtho.2016.11.2134" @default.
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