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

Nestor Villamizar, Marcus Darrabie, Jennifer Hanna, Mark W. Onaitis, Betty C. Tong, Thomas A. D'Amico, Mark F. Berry

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)514-521
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume145
Issue number2
DOIs
StatePublished - Feb 2013
Externally publishedYes

Fingerprint

Lung Neoplasms
Neoplasms
Morbidity
Multivariate Analysis
Forced Expiratory Volume
Thoracotomy
Heart Failure
Logistic Models
Drug Therapy
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer. / Villamizar, Nestor; Darrabie, Marcus; Hanna, Jennifer; Onaitis, Mark W.; Tong, Betty C.; D'Amico, Thomas A.; Berry, Mark F.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 145, No. 2, 02.2013, p. 514-521.

Research output: Contribution to journalArticle

Villamizar, Nestor ; Darrabie, Marcus ; Hanna, Jennifer ; Onaitis, Mark W. ; Tong, Betty C. ; D'Amico, Thomas A. ; Berry, Mark F. / Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer. In: Journal of Thoracic and Cardiovascular Surgery. 2013 ; Vol. 145, No. 2. pp. 514-521.
@article{2189e92b780b4b9baa5960f75d851c99,
title = "Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer",
abstract = "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.",
author = "Nestor Villamizar and Marcus Darrabie and Jennifer Hanna and Onaitis, {Mark W.} and Tong, {Betty C.} and D'Amico, {Thomas A.} and Berry, {Mark F.}",
year = "2013",
month = "2",
doi = "10.1016/j.jtcvs.2012.10.039",
language = "English (US)",
volume = "145",
pages = "514--521",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Impact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer

AU - Villamizar, Nestor

AU - Darrabie, Marcus

AU - Hanna, Jennifer

AU - Onaitis, Mark W.

AU - Tong, Betty C.

AU - D'Amico, Thomas A.

AU - Berry, Mark F.

PY - 2013/2

Y1 - 2013/2

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84872289228&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872289228&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2012.10.039

DO - 10.1016/j.jtcvs.2012.10.039

M3 - Article

C2 - 23177123

AN - SCOPUS:84872289228

VL - 145

SP - 514

EP - 521

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 2

ER -