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Objective:Current practice guidelines by the National Comprehensive Cancer Network (NCCN) recommend the complete dissection of at least three mediastinal nodal stations during lobectomy for lung cancer. Controversy exists concerning the adequacy of lymph node sampling (LNS) achieved by video assisted thoracic surgery (VATS) lobectomy for lung cancer and furthermore whether or not small volume centers could compare to the national benchmarks. Several large studies have shown conflicting evidence concerning the LNS yield in VATS vs thoracotomy. For thoracic surgeons in a rural community setting there may be warranted concern about the adequacy of lymph node dissection during VATS. This study aimed to assess the adequacy of lymph node sampling by VATS at our institution, a rural 300 bed community teaching hospital in western Massachusetts.
Design:Retrospective review of clinical and pathological data were reviewed from 2010-2016
Patients:103 hospital admissions in patients undergoing lung Lobectomy
Main Outcome Measures: Variables included age, sex, number of mediastinal nodes and node stations dissected.
Results:103 patients with 103 VATs Lobectomies, 49 males (ave age 64.6 yrs) and 55 females (ave age 67.5), had a mean number of mediastinal lymph nodes (MLD) of 10.98 and the mean number of dissected MLN stations of 3.47.
Conclusions: This study agrees with previous data affirming the lymph node yield is adequate with VATs lobectomy. When compared to the current NCCN recommendations our institutions mean number of MLN and MLN stations dissected is similar or better to that of many larger volume centers across the nation and supports the adequacy of VATs Lobectomy in rural community hospitals.