title: Efficacy of mediastinal lymph node dissection during lobectomy for lung cancer by thoracoscopy and thoracotomy.
abstract: BACKGROUND
  Mediastinal lymph node dissection (MLND) is an integral component of complete resection for non-small cell lung cancer (NSCLC). This study analyzed the National Comprehensive Cancer Network's (NCCN) NSCLC Database to compare the efficacy of MLND during lobectomy by video-assisted thoracoscopy surgery (VATS) and thoracotomy (open).
  
  
  METHODS
  The NCCN NSCLC Database was queried to identify patients who underwent lobectomy to analyze the adequacy of MLND by the number of LN stations. The percentage of patients with at least three N2 stations, the number of N2 LN stations, and the total number of LN stations (N1+N2) resected was compared by approach.
  
  
  RESULTS
  Of 4215 patients with NSCLC (January 2007 to September 2010), 388 patients underwent lobectomy (199 VATS and 189 open) and met entry criteria. The groups were similar in age, sex, comorbidities, performance status, and histology. MLN assessment was similar in both groups as measured by number of N2 stations (median, 3 stations; p=0.12). At least three MLN stations were assessed in 130 patients (66%) in the VATS group vs 107 patients (58%) in the open group (p=0.12). The total number of N1+N2 stations resected for each group was also similar (median, 4 in both groups (p=0.06).
  
  
  CONCLUSIONS
  The NCCN database indicates at least three MLN stations were assessed in most patients who underwent lobectomy by either approach. As evaluated by the number of LN stations, there was no difference in the efficacy of MLN dissection by approach.
authors: Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA. damic001@mc.duke.edu
authors: Thomas A
authors: TA
authors: D'Amico
authors: Joyce
authors: J
authors: Niland
authors: Rizvan
authors: R
authors: Mamet
authors: Carrie
authors: C
authors: Zornosa
authors: Elisabeth U
authors: EU
authors: Dexter
authors: Mark W
authors: MW
authors: Onaitis
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D008482:Mediastinum / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality; D049268:Positron-Emission Tomography; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods* / Q000401:mortality; D013906:Thoracoscopy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome