Universität zu Köln

Schlachtenberger, Georg ORCID: 0000-0001-7118-8432, Doerr, Fabian, Menghesha, Hruy, Hagmeyer, Lars, Bennink, Gerardus, Gaisendrees, Christopher, Wahlers, Thorsten, Hekmat, Khosro and Heldwein, Matthias B. (2022). Sublobar resection without staging and lymphadenectomy for=2 cm Non-Small Cell Lung Cancer is no adequate therapy. Surg. Oncol.-Oxf., 44. OXFORD: ELSEVIER SCI LTD. ISSN 1879-3320

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Abstract

Objective: Sublobar resection is frequently performed for Non-Small Cell Lung Cancer (NSCLC) patients with <= 2 cm nodules. Frequently, both proper staging and radical lymphadenectomy are omitted in these operations. Therefore, we decided to evaluate the number of lymph node metastases and the number of postoperative nodal upstaging in patients undergoing pulmonary resection due to NSCLC with tumors <= 2 cm at our institution. Methods: Nodal upstaging, lymphangiosis-(L1), and hemangiosis carcinomatosa (V1) were analyzed. pN0 patients were compared to patients with postoperative nodal upstaging. One-, three, and five-year survival rates were measured. Survival was also assessed by the Kaplan-Meier method. Results: 747 patients underwent surgery for NSCLC at our institution between 2012 and 2020. We retrospectively reviewed data of 236 NSCLC patients with <= 2 cm tumors. The mean tumor size was 1.4 cm +/- 0.39 in our cohort. Of our patients, 14% showed a cT1a tumor, and 86% of patients cT1b. 24.0 +/- 12.3 lymph nodes were dissected and analyzed per patient, and 0.7 +/- 2.0 of those were affected. Of our patients, 16.1% showed L1 affection, and 7.6% a V1 affection. Lymph node involvement was diagnosed in 11(4.7%) patients preoperatively. 39(16.5%) patients were upstaged due to lymph node involvement postoperatively (p < 0.001). Upstaged patients showed significantly worse 3-(upstaged: 60.6% vs. pN0: 83.2%; p = 0.01) and 5-year (upstages: 38% vs. pN0 71.5%; p = 0.02) survival rates. Conclusion: 16.5% of patients with <= 2 cm NSCLC were nodal upstaged postoperatively. These results underline that lymphadenectomy and proper staging are crucial for NSCLC patients irrespective of the tumor size and the surgical approach.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schlachtenberger, Georg UNSPECIFIED orcid.org/0000-0001-7118-8432 UNSPECIFIED Doerr, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Menghesha, Hruy UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagmeyer, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Bennink, Gerardus UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaisendrees, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hekmat, Khosro UNSPECIFIED UNSPECIFIED UNSPECIFIED Heldwein, Matthias B. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-662610
DOI:	10.1016/j.suronc.2022.101840
Journal or Publication Title:	Surg. Oncol.-Oxf.
Volume:	44
Date:	2022
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-3320
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLINICAL-PRACTICE GUIDELINES; RECURRENCE; LOBECTOMY Multiple languages Oncology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66261