Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data
The outcomes of non-small cell lung cancer surgery are influenced by the quality of lymphadenectomy. This study aimed to evaluate the impact of different energy devices on lymphadenectomy quality and identify additional influencing factors. This secondary analysis of the prospective randomized trial...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/11/3780 |
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| author | Piotr Gabryel Magdalena Roszak Piotr Skrzypczak Anna Gabryel Dominika Zielińska Magdalena Sielewicz Alessio Campisi Mariusz Kasprzyk Cezary Piwkowski |
| author_facet | Piotr Gabryel Magdalena Roszak Piotr Skrzypczak Anna Gabryel Dominika Zielińska Magdalena Sielewicz Alessio Campisi Mariusz Kasprzyk Cezary Piwkowski |
| author_sort | Piotr Gabryel |
| collection | DOAJ |
| description | The outcomes of non-small cell lung cancer surgery are influenced by the quality of lymphadenectomy. This study aimed to evaluate the impact of different energy devices on lymphadenectomy quality and identify additional influencing factors. This secondary analysis of the prospective randomized trial data (clinicaltrials.gov: NCT03125798) compared patients who underwent thoracoscopic lobectomy with the LigaSure device (study group, <i>n</i> = 96) and monopolar device (control group, <i>n</i> = 94). The primary endpoint was the lobe-specific mediastinal lymphadenectomy. Lobe-specific mediastinal lymphadenectomy criteria were met in 60.4% and 38.3% of patients in the study and control groups, respectively (<i>p =</i> 0.002). In addition, in the study group, the median number of mediastinal lymph node stations removed was higher (4 vs. 3, <i>p =</i> 0.017), and complete resection was more often achieved (91.7% vs. 80.9%, <i>p =</i> 0.030). Logistic regression analysis indicated that lymphadenectomy quality was positively associated with the use of the LigaSure device (OR, 2.729; 95% CI, 1.446 to 5.152; <i>p =</i> 0.002) and female sex (OR, 2.012; 95% CI, 1.058 to 3.829; <i>p =</i> 0.033), but negatively associated with a higher Charlson Comorbidity Index (OR, 0.781; 95% CI, 0.620 to 0.986; <i>p =</i> 0.037), left lower lobectomy (OR, 0.263; 95% CI, 0.096 to 0.726; <i>p =</i> 0.010) and middle lobectomy (OR, 0.136; 95% CI, 0.031 to 0.606, <i>p =</i> 0.009). This study found that using the LigaSure device can improve the quality of lymphadenectomy in lung cancer patients and also identified other factors that affect the quality of lymphadenectomy. These findings contribute to improving lung cancer surgical treatment outcomes and provide valuable insights for clinical practice. |
| first_indexed | 2024-03-11T03:03:34Z |
| format | Article |
| id | doaj.art-5a35cf848e26445480861e9a27400447 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:03:34Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5a35cf848e26445480861e9a274004472023-11-18T08:06:21ZengMDPI AGJournal of Clinical Medicine2077-03832023-05-011211378010.3390/jcm12113780Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial DataPiotr Gabryel0Magdalena Roszak1Piotr Skrzypczak2Anna Gabryel3Dominika Zielińska4Magdalena Sielewicz5Alessio Campisi6Mariusz Kasprzyk7Cezary Piwkowski8Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, PolandDepartment of Computer Science and Statistics, Poznan University of Medical Sciences, Rokietnicka 7 Street, 60-806 Poznan, PolandDepartment of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, PolandDepartment of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, PolandDepartment of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, PolandDepartment of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, PolandDepartment of Thoracic Surgery, University and Hospital Trust–Ospedale Borgo Trento, Piazzale Aristide Stefani 1, 37126 Verona, ItalyDepartment of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, PolandDepartment of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, PolandThe outcomes of non-small cell lung cancer surgery are influenced by the quality of lymphadenectomy. This study aimed to evaluate the impact of different energy devices on lymphadenectomy quality and identify additional influencing factors. This secondary analysis of the prospective randomized trial data (clinicaltrials.gov: NCT03125798) compared patients who underwent thoracoscopic lobectomy with the LigaSure device (study group, <i>n</i> = 96) and monopolar device (control group, <i>n</i> = 94). The primary endpoint was the lobe-specific mediastinal lymphadenectomy. Lobe-specific mediastinal lymphadenectomy criteria were met in 60.4% and 38.3% of patients in the study and control groups, respectively (<i>p =</i> 0.002). In addition, in the study group, the median number of mediastinal lymph node stations removed was higher (4 vs. 3, <i>p =</i> 0.017), and complete resection was more often achieved (91.7% vs. 80.9%, <i>p =</i> 0.030). Logistic regression analysis indicated that lymphadenectomy quality was positively associated with the use of the LigaSure device (OR, 2.729; 95% CI, 1.446 to 5.152; <i>p =</i> 0.002) and female sex (OR, 2.012; 95% CI, 1.058 to 3.829; <i>p =</i> 0.033), but negatively associated with a higher Charlson Comorbidity Index (OR, 0.781; 95% CI, 0.620 to 0.986; <i>p =</i> 0.037), left lower lobectomy (OR, 0.263; 95% CI, 0.096 to 0.726; <i>p =</i> 0.010) and middle lobectomy (OR, 0.136; 95% CI, 0.031 to 0.606, <i>p =</i> 0.009). This study found that using the LigaSure device can improve the quality of lymphadenectomy in lung cancer patients and also identified other factors that affect the quality of lymphadenectomy. These findings contribute to improving lung cancer surgical treatment outcomes and provide valuable insights for clinical practice.https://www.mdpi.com/2077-0383/12/11/3780lung cancersurgerylobe-specificlymphadenectomyminimally invasive surgerylobectomy |
| spellingShingle | Piotr Gabryel Magdalena Roszak Piotr Skrzypczak Anna Gabryel Dominika Zielińska Magdalena Sielewicz Alessio Campisi Mariusz Kasprzyk Cezary Piwkowski Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data Journal of Clinical Medicine lung cancer surgery lobe-specific lymphadenectomy minimally invasive surgery lobectomy |
| title | Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data |
| title_full | Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data |
| title_fullStr | Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data |
| title_full_unstemmed | Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data |
| title_short | Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data |
| title_sort | identification of factors related to the quality of lymphadenectomy for lung cancer secondary analysis of prospective randomized trial data |
| topic | lung cancer surgery lobe-specific lymphadenectomy minimally invasive surgery lobectomy |
| url | https://www.mdpi.com/2077-0383/12/11/3780 |
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