Spanish Lung Cancer Group SCAT trial: surgical audit to lymph node assessment based on IASLC recommendations
Jarabo Sarceda, José Ramón ; Bolufer Nadal, Sergio ; Mongil Poce, Roberto ; López de Castro, Pedro ; Moreno Balsalobre, Ramón ; Peñalver Cuesta, Juan Carlos ; Embún Flor, Raul (Universidad de Zaragoza) ; Pac Ferrer, Joaquín ; Algar Algar, Francisco Javier ; Gámez García, Antonio Pablo ; Jiménez, Marcelo F. ; Sales-Badía, Jesús Gabriel ; Pereira, Eva ; Massuti, Bartomeu ; Provencio, Mariano ; Hernando Trancho, Florentino
Resumen: Background: The Spanish Customized Adjuvant Therapy (SCAT) trial assessed the role of individualized adjuvant therapy in clinical N0 incidental pN1 and/or N2 non-small cell lung cancer (NSCLC) completely resected. We assessed surgical topics with an in-depth analysis of quality of lymphadenectomy based on International Association for the Study of Lung Cancer (IASLC) recommendations.
Methods: Patients with information about lymphadenectomy available were included (N=451). Prospectively collected data about tumor, type of resection, and postoperative morbidity and quality of lymph node dissection (LND) were retrospectively evaluated. Role of lymph node assessment on survival was analyzed using Kaplan-Meier curves, using regression models to identify prognostic factors.
Results: In 33.7%, 17.7% and 49.9% of cases, regions 7, 10 and 11 respectively were not assessed. In 21.1% of patients, less than three lymph node regions were biopsied, while in 19.6% of patients less than six lymph nodes were assessed. In 53,4% of patients only one N1 region was evaluated. From patients with positive N2, 8.9% had no N1 regions biopsied. Twenty-nine percent of patients with at least one N2 lymph node resected shown the highest region involved. Thirty-day postoperative mortality was unknown. Five-year overall survival (OS) was 61.7% (95% CI: 55.4–67.4%), 51.5% (95% CI: 39.2–62.4%) and 42.3% (95% CI: 32.1–52.2%) for patients with N1, N2 and N1+N2 disease, respectively (P<0.01). Both number of lymph nodes resected and number of lymph nodes involved by tumor were significantly related to prognosis.
Conclusions: IASLC recommendations for surgical resections were not followed in a high proportion of surgical procedures. Hilar and mediastinal lymph node assessment and involvement showed to impact prognosis. Surgical issues such as postoperative mortality could not be evaluated owing to trial design.
Idioma: Alemán
DOI: 10.21037/tlcr-20-1055
Año: 2021
Publicado en: Translational lung cancer research 10, 4 (2021), 1761-1772
ISSN: 2218-6751
Factor impacto JCR: 4.726 (2021)
Categ. JCR: RESPIRATORY SYSTEM rank: 24 / 66 = 0.364 (2021) - Q2 - T2
Categ. JCR: ONCOLOGY rank: 105 / 245 = 0.429 (2021) - Q2 - T2
Factor impacto CITESCORE: 4.8 - Medicine (Q2)
Factor impacto SCIMAGO: 1.067 - Oncology (Q2)
Tipo y forma: Article (Published version)
Área (Departamento): Área Cirugía (Dpto. Cirugía)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
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Methods: Patients with information about lymphadenectomy available were included (N=451). Prospectively collected data about tumor, type of resection, and postoperative morbidity and quality of lymph node dissection (LND) were retrospectively evaluated. Role of lymph node assessment on survival was analyzed using Kaplan-Meier curves, using regression models to identify prognostic factors.
Results: In 33.7%, 17.7% and 49.9% of cases, regions 7, 10 and 11 respectively were not assessed. In 21.1% of patients, less than three lymph node regions were biopsied, while in 19.6% of patients less than six lymph nodes were assessed. In 53,4% of patients only one N1 region was evaluated. From patients with positive N2, 8.9% had no N1 regions biopsied. Twenty-nine percent of patients with at least one N2 lymph node resected shown the highest region involved. Thirty-day postoperative mortality was unknown. Five-year overall survival (OS) was 61.7% (95% CI: 55.4–67.4%), 51.5% (95% CI: 39.2–62.4%) and 42.3% (95% CI: 32.1–52.2%) for patients with N1, N2 and N1+N2 disease, respectively (P<0.01). Both number of lymph nodes resected and number of lymph nodes involved by tumor were significantly related to prognosis.
Conclusions: IASLC recommendations for surgical resections were not followed in a high proportion of surgical procedures. Hilar and mediastinal lymph node assessment and involvement showed to impact prognosis. Surgical issues such as postoperative mortality could not be evaluated owing to trial design.
Idioma: Alemán
DOI: 10.21037/tlcr-20-1055
Año: 2021
Publicado en: Translational lung cancer research 10, 4 (2021), 1761-1772
ISSN: 2218-6751
Factor impacto JCR: 4.726 (2021)
Categ. JCR: RESPIRATORY SYSTEM rank: 24 / 66 = 0.364 (2021) - Q2 - T2
Categ. JCR: ONCOLOGY rank: 105 / 245 = 0.429 (2021) - Q2 - T2
Factor impacto CITESCORE: 4.8 - Medicine (Q2)
Factor impacto SCIMAGO: 1.067 - Oncology (Q2)
Tipo y forma: Article (Published version)
Área (Departamento): Área Cirugía (Dpto. Cirugía)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2025-10-17-14:14:15)
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Record created 2025-08-29, last modified 2025-10-17