• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Impact of Number of Lymph Nodes in Lung Cancer Resection on Survival: A 10-Year Experience in a Department of Defense Institution to Include Quality of Lymph Node Sampling, Operative Procedure, Staging, and 5-year Survival

Bethany M Heidenreich, CPT, DO, Andrew S Durkee, CPT, DO, Julia O Bader, PhD, Vincent J Mase Jr., LTC, MD. William Beaumont Army Medical Center

Objectives: Assess a 10-year experience at our institution with regard to thoracic oncology, to include quality of regional lymph node (RLN) dissection as compared to the Commission on Cancer (CoC) surveillance measure 10RLN, stage, operative procedure, and the impact of number of RLN examined on 5-year survival.

Methods: A 10-year query of our Automated Central Tumor Registry (ACTUR) database was performed to identify all stages of lung cancer patients who received lung resection as part of their treatment at our institution from 2005 through 2015. Initial evaluation was performed to report the general demographics of our institution with regard to thoracic surgical oncology over the past 10 years. The data was further refined to evaluate only cases of stage I and II resected NSCLC diagnosed since 2010, according to the parameters of the CoC surveillance measure 10RLN. Logistic regression analysis was performed to determine whether the examination of ?10 RLN, is associated with increased odds of survival. Survival curves were estimated using the Kaplan-Meier method. The log rank test and Cox proportional hazard analysis were performed to evaluate the effect of number of RLN examined on survival.

Results: 83 cases performed at our institution from 2005-2015 included the following surgeries: 21 wedge resections, 56 lobectomies, and 6 pneumonectomies. The demographics were predominantly male (77.1%), white (80.7%), age 60-69 (44.6%), with a positive smoking history (49.4%). The cancers were pathologically stage I (57.8%), stage II (22.9%), stage III (6.0%), stage IV (4.8%), and unknown (8.4%). The majority of the cancers were poorly differentiated (50.6%) adenocarcinomas (56.6%). Median survival was 5.7 years. The median RLN examined was 7. 70% of resections at our institution from 2010-2015, for NSCLC stage I and II, did not meet the CoC surveillance measure 10RLN. Logistic regression analysis comparing ?10 versus <10 RLN for predicting 5-year survival, and Cox models adjusting for sex, age, histology and surgery showed no significance. Kaplan-Meier survival curves were also not significant.

Conclusions: A majority of resections performed at our institution did not meet the CoC surveillance measure of ?10 RLN examined in stage I and II resected NSCLC. Quality improvement projects are currently planned with our cancer center. The number of RLN examined had no significant impact on survival. However, the study was underpowered. We are currently conducting a DoD-wide, multi-center analysis of these same factors. This investigation should be appropriately powered to determine if this surveillance measure correlates with improved survival.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 88297

Program Number: MSS18

Presentation Session: Full-Day Military Surgical Symposium – General Surgery Presentations

Presentation Type: MSSPodium

8

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons