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Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer.

Publication ,  Journal Article
Villamizar, NR; Darrabie, M; Hanna, J; Onaitis, MW; Tong, BC; D'Amico, TA; Berry, MF
Published in: J Thorac Cardiovasc Surg
February 2013

OBJECTIVE: We sought to evaluate the effect of tumor size, location, and clinical nodal status on outcomes after thoracoscopic lobectomy for lung cancer. METHODS: All patients who underwent attempted thoracoscopic lobectomy for lung cancer between June 1999 and October 2010 at a single institution were reviewed. A model for morbidity including published risk factors as well as tumor size, location, and clinical N status was developed by multivariable logistic regression. RESULTS: During the study period, 916 thoracoscopic lobectomies met study criteria: 329 for peripheral, clinical N0 tumors ≤ 3 cm and 504 for tumors that were central, clinical node positive, or >3 cm. Tumor location could not be documented for 83 patients. Conversions to thoracotomy occurred in 36 patients (4%); patients with clinically node-positive disease had higher conversion rates (11 conversions in 153 clinical N1 to N3 patients [7.2%] vs 25 in 763 clinical N0 patients [3.3%, P = .03]. Overall operative mortality was 1.6% (14 patients) and morbidity was 32% (296 patients). Although patients with larger tumors (P = .006) and central tumors (P = .01) had increased complications by univariate analysis, tumor size >3 cm (P = .17) and central location (P = .5) did not predict significantly overall morbidity in multivariate analysis. Clinical node status did not predict increased complications by univariate or multivariate analysis. Significant predictors of morbidity in multivariable analysis were increasing age, decreasing forced expiratory volume in 1 second, prior chemotherapy, and congestive heart failure. CONCLUSIONS: Thoracoscopic lobectomy for lung cancers that are central, clinically node positive, or >3 cm does not confer increased morbidity compared with peripheral, clinical N0 cancers that are <3 cm.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

February 2013

Volume

145

Issue

2

Start / End Page

514 / 520

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Thoracic Surgery, Video-Assisted
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Propensity Score
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Villamizar, N. R., Darrabie, M., Hanna, J., Onaitis, M. W., Tong, B. C., D’Amico, T. A., & Berry, M. F. (2013). Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer. J Thorac Cardiovasc Surg, 145(2), 514–520. https://doi.org/10.1016/j.jtcvs.2012.10.039
Villamizar, Nestor R., Marcus Darrabie, Jennifer Hanna, Mark W. Onaitis, Betty C. Tong, Thomas A. D’Amico, and Mark F. Berry. “Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer.J Thorac Cardiovasc Surg 145, no. 2 (February 2013): 514–20. https://doi.org/10.1016/j.jtcvs.2012.10.039.
Villamizar NR, Darrabie M, Hanna J, Onaitis MW, Tong BC, D’Amico TA, et al. Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer. J Thorac Cardiovasc Surg. 2013 Feb;145(2):514–20.
Villamizar, Nestor R., et al. “Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer.J Thorac Cardiovasc Surg, vol. 145, no. 2, Feb. 2013, pp. 514–20. Pubmed, doi:10.1016/j.jtcvs.2012.10.039.
Villamizar NR, Darrabie M, Hanna J, Onaitis MW, Tong BC, D’Amico TA, Berry MF. Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer. J Thorac Cardiovasc Surg. 2013 Feb;145(2):514–520.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

February 2013

Volume

145

Issue

2

Start / End Page

514 / 520

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Thoracic Surgery, Video-Assisted
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Propensity Score