000162597 001__ 162597 000162597 005__ 20251017144647.0 000162597 0247_ $$2doi$$a10.1016/j.lungcan.2022.01.004 000162597 0248_ $$2sideral$$a145070 000162597 037__ $$aART-2022-145070 000162597 041__ $$aeng 000162597 100__ $$aObiols, Carme 000162597 245__ $$aRadicality of lymphadenectomy in lung cancer resections by thoracotomy and video-assisted thoracoscopic approach: A prospective, multicentre and propensity-score adjusted study 000162597 260__ $$c2022 000162597 5203_ $$aObjective: To analyse differences in intraoperative nodal assessment in patients undergoing lung cancer resection by thoracotomy and video-assisted thoracoscopy (VATS) in the Spanish Video-Assisted Thoracic Surgery Group (GEVATS). Methods: Prospective multicentre cohort study of anatomic pulmonary resections (n = 3533) performed from December 2016 to March 2018. Main surgical, clinical and oncological variables related with lymphadenectomy were compared according to surgical approach. Corresponding tests for homogeneity were performed. Multiple logistic regression analyses were used to determine the odds ratio (OR) and 95% confidence interval (95%CI). Covariate adjustment using the propensity score (PS) was performed to reduce confounding effects. Results: After exclusions, 2532 patients were analysed. Systematic nodal dissection (SND) was performed in 65%, with a median of resected/sampled lymph nodes (LN) of 7 (IQR 4–12) and pathologic (p) N2 and uncertain (u) pNu rates of 9.4% and 28.9%, respectively. At multivariate analysis, the following were associated with thoracotomy (OR; 95%CI): SND (1.4; 1.08–1.96; p = 0.014), staging mediastinoscopy (2.6; 1.59–4.25; p < 0.001), tumor > 3 cm (2.1; 1.66–2.78; p < 0.001), central tumor (2.5; 1.90–3.24; p < 0.001); pN1 (1.8; 1.25–2.67; p < 0.002), pN2 (1.8; 1.18–2.76; p = 0.006), lower FEV1 (0.9; 0.98–0.99; p < 0.001), squamous cell carcinoma (1.5; 1.16–1.98; p = 0.002) and inexperienced surgeons in VATS (compared with > 100 VATS experience) (37.6; 13.55–104.6; p < 0.001). After PS adjustment, SND maintained the OR, but in the limit of signification (1.4; 1–1.98; p = 0.05). Nodal upstaging was significantly higher in the thoracotomy group. Complication rates of SND and no SND were similar. Conclusions: Thoracotomy was associated with a more thorough lymphadenectomy in GEVATS. Therefore, intraoperative lymph node evaluation performed at VATS should be improved to have better prognostic information and more solid grounds to indicate adjuvant therapy. 000162597 540__ $$9info:eu-repo/semantics/closedAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000162597 590__ $$a5.3$$b2022 000162597 591__ $$aRESPIRATORY SYSTEM$$b18 / 66 = 0.273$$c2022$$dQ2$$eT1 000162597 591__ $$aONCOLOGY$$b70 / 241 = 0.29$$c2022$$dQ2$$eT1 000162597 592__ $$a1.609$$b2022 000162597 593__ $$aCancer Research$$c2022$$dQ1 000162597 593__ $$aPulmonary and Respiratory Medicine$$c2022$$dQ1 000162597 593__ $$aOncology$$c2022$$dQ1 000162597 594__ $$a10.3$$b2022 000162597 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000162597 700__ $$aCall, Sergi 000162597 700__ $$aRami-Porta, Ramón 000162597 700__ $$aJaén, Ángeles 000162597 700__ $$aGómez de Antonio, David 000162597 700__ $$aCrowley Carrasco, Silvana 000162597 700__ $$aRoyo-Crespo, Íñigo 000162597 700__ $$0(orcid)0000-0003-0249-3104$$aEmbún, Raúl$$uUniversidad de Zaragoza 000162597 7102_ $$11013$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Cirugía 000162597 773__ $$g165 (2022), 63-70$$pLung cancer$$tLUNG CANCER$$x0169-5002 000162597 8564_ $$s543727$$uhttps://zaguan.unizar.es/record/162597/files/texto_completo.pdf$$yVersión publicada 000162597 8564_ $$s2243826$$uhttps://zaguan.unizar.es/record/162597/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000162597 909CO $$ooai:zaguan.unizar.es:162597$$particulos$$pdriver 000162597 951__ $$a2025-10-17-14:34:41 000162597 980__ $$aARTICLE