Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy
Abstract Background Lymph node upstaging represents a quality criterion for standardized lymphadenectomy in lung cancer surgery. The aim of the study was to compare whether the quality of standardized lymphadenectomy in lung cancer surgery is comparable in minimally invasive (video-assisted thoracos...
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BMC
2025-01-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03346-5 |
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| author | Julia Zimmermann Julia Walter Valentina Pfeiffer Julia Kovács Gökçe Yavuz Johannes Schön Mircea Gabriel Stoleriu Christian Ketscher Niels Reinmuth Rudolf A. Hatz Amanda Tufman Christian P. Schneider |
| author_facet | Julia Zimmermann Julia Walter Valentina Pfeiffer Julia Kovács Gökçe Yavuz Johannes Schön Mircea Gabriel Stoleriu Christian Ketscher Niels Reinmuth Rudolf A. Hatz Amanda Tufman Christian P. Schneider |
| author_sort | Julia Zimmermann |
| collection | DOAJ |
| description | Abstract Background Lymph node upstaging represents a quality criterion for standardized lymphadenectomy in lung cancer surgery. The aim of the study was to compare whether the quality of standardized lymphadenectomy in lung cancer surgery is comparable in minimally invasive (video-assisted thoracoscopic surgery) and the open approach (thoracotomy). Furthermore, factors associated with lymph node upstaging were assessed, as was its impact on overall survival and progression-free survival. Methods This retrospective study reviewed data of all patients undergoing lobectomy at the Lung Tumor Center Munich between 2011 and 2020. Inclusion factors were non-small cell lung cancer without nodal involvement (N0) or metastasis (M0) and standardized lymphadenectomy. A propensity score matched analyses was performed. Frequency of categorical outcomes was compared with Chi [2]-test, mean values with t-test. We used logistic and Cox regression models to assess factors associated with upstaging, overall survival and progression-free survival, restrictively. Results Of 1691 patients undergoing lobectomy, 637 met our inclusion criteria. After propensity score matching 198 patients remained in each group. Univariate analysis showed no significant difference in lymph node upstaging between the two groups. (p = 0.12). Overall affected lymph nodes (p = 0.45) and overall affected lymph node stations (p = 0.26) were not significantly different. Multivariate Cox regression analysis showed that overall survival and progression free survival were also independent of the surgical approach. L1 status was the only factor associated with progression-free survival. Conclusion Minimally invasive approaches achieves comparable lymph node upstaging in patients undergone standardized lymphadenectomy. |
| format | Article |
| id | doaj-art-1b8cf32517f644c0a604bea5f7525e1d |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-1b8cf32517f644c0a604bea5f7525e1d2025-02-02T12:42:06ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-0120111210.1186/s13019-025-03346-5Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomyJulia Zimmermann0Julia Walter1Valentina Pfeiffer2Julia Kovács3Gökçe Yavuz4Johannes Schön5Mircea Gabriel Stoleriu6Christian Ketscher7Niels Reinmuth8Rudolf A. Hatz9Amanda Tufman10Christian P. Schneider11Division of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDepartment of Internal Medicine V, LMU University Hospital, LMUDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDepartment of Thoracic Oncology, Asklepios Lung ClinicDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicDepartment of Internal Medicine V, LMU University Hospital, LMUDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung ClinicAbstract Background Lymph node upstaging represents a quality criterion for standardized lymphadenectomy in lung cancer surgery. The aim of the study was to compare whether the quality of standardized lymphadenectomy in lung cancer surgery is comparable in minimally invasive (video-assisted thoracoscopic surgery) and the open approach (thoracotomy). Furthermore, factors associated with lymph node upstaging were assessed, as was its impact on overall survival and progression-free survival. Methods This retrospective study reviewed data of all patients undergoing lobectomy at the Lung Tumor Center Munich between 2011 and 2020. Inclusion factors were non-small cell lung cancer without nodal involvement (N0) or metastasis (M0) and standardized lymphadenectomy. A propensity score matched analyses was performed. Frequency of categorical outcomes was compared with Chi [2]-test, mean values with t-test. We used logistic and Cox regression models to assess factors associated with upstaging, overall survival and progression-free survival, restrictively. Results Of 1691 patients undergoing lobectomy, 637 met our inclusion criteria. After propensity score matching 198 patients remained in each group. Univariate analysis showed no significant difference in lymph node upstaging between the two groups. (p = 0.12). Overall affected lymph nodes (p = 0.45) and overall affected lymph node stations (p = 0.26) were not significantly different. Multivariate Cox regression analysis showed that overall survival and progression free survival were also independent of the surgical approach. L1 status was the only factor associated with progression-free survival. Conclusion Minimally invasive approaches achieves comparable lymph node upstaging in patients undergone standardized lymphadenectomy.https://doi.org/10.1186/s13019-025-03346-5Non-small cell lung cancerLymphadenectomyPropensity score matchingTumor stagingThoracotomyVideo-assisted thoracoscopic surgery |
| spellingShingle | Julia Zimmermann Julia Walter Valentina Pfeiffer Julia Kovács Gökçe Yavuz Johannes Schön Mircea Gabriel Stoleriu Christian Ketscher Niels Reinmuth Rudolf A. Hatz Amanda Tufman Christian P. Schneider Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy Journal of Cardiothoracic Surgery Non-small cell lung cancer Lymphadenectomy Propensity score matching Tumor staging Thoracotomy Video-assisted thoracoscopic surgery |
| title | Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy |
| title_full | Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy |
| title_fullStr | Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy |
| title_full_unstemmed | Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy |
| title_short | Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy |
| title_sort | propensity score matched comparison of lymph node upstaging in early stage lung cancer open versus minimally invasive surgery with standardized lymphadenectomy |
| topic | Non-small cell lung cancer Lymphadenectomy Propensity score matching Tumor staging Thoracotomy Video-assisted thoracoscopic surgery |
| url | https://doi.org/10.1186/s13019-025-03346-5 |
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