An evaluation of lymph node harvest in sublobar resections in a statewide quality collaborative
Recommended Citation
Bui J, Kalata S, Reddy RM, Clark M, Hollenbeck M, Mollberg N, Lall S, and Popoff AM. An Evaluation of Lymph Node Harvest in Sublobar Resections in a Statewide Quality Collaborative. J Thorac Cardiovasc Surg 2025.
Document Type
Article
Publication Date
2-27-2025
Publication Title
The Journal of thoracic and cardiovascular surgery
Abstract
OBJECTIVE: Evaluate the effectiveness of nodal harvest in sublobar resections for peripheral non-small cell lung cancer.
METHODS: Retrospective review of prospectively collected data for patients who underwent wedge resection (WR) and segmentectomy (SG) for non-small cell lung cancer from January 2015 to March 2023 at 21 centers within a statewide quality collaborative. The primary end point was the extent of lymph node (LN) harvest defined as ≥ 10 LNs, ≥ 5 LN stations (LNSs), or 3 mediastinal LNSs and 1 hilar LNS (3/1 LNS). We also examined the LN harvest stratified by operative approach (open, video-assisted, or robot-assisted).
RESULTS: A total of 1398 patients receiving sublobar resections were reviewed: 919 (65.7%) with WR and 479 (34.3%) with SG. Only 15.6% (152) WR and 54.6% (263) SG had an adequate number of LNSs harvested. Robot-assisted thoracic surgery was associated with higher rates of harvesting ≥ 10 LNs (P < .001) or harvesting ≥ 5 LNSs or 3/1 LNS (P < .001) compared with video-assisted thoracoscopic surgery for WR. Compared with open procedures and video-assisted thoracic surgery, Robot-assisted thoracic surgery was associated with higher rates of harvesting ≥ 5 LNSs or 3/1 LNS for SG (P = .002 and P = .003, respectively).
CONCLUSIONS: WR and SG have low rates of adequate LN harvesting. Robot-assisted surgery was associated with improved LN harvesting rates. Given the increase interest in sublobar resections, continued focus on improving and increasing LN harvesting are needed.
Medical Subject Headings
Humans; Retrospective Studies; Lymph Node Excision/methods/adverse effects; Male; Female; Pneumonectomy/methods/adverse effects; Carcinoma; Non-Small-Cell Lung/surgery/pathology; Lung Neoplasms/surgery/pathology; Aged; Middle Aged; Thoracic Surgery; Video-Assisted/adverse effects; Lymph Nodes/pathology/surgery; Robotic Surgical Procedures/adverse effects; Treatment Outcome; lymph node harvesting; sublobar resection; surgical approach
PubMed ID
40023483
ePublication
ePub ahead of print
Volume
170
Issue
4
First Page
915
Last Page
9.23E+04
