Epithor

Dahan, M.

doi:10.1016/j.rmr.2020.09.002

Cited by 9 publications

(3 citation statements)

References 24 publications

(24 reference statements)

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“…We conducted a multicentre retrospective study of the French nationwide prospective database Epithor [ 6 ], including all adult patients who underwent anatomical lung resection for primary NSCLC from January 2010 to October 2021 in 83 French thoracic centres ( supplementary table S1 ). Adult patients who underwent an anatomical lung resection for primary NSCLC were included.…”

Section: Methodsmentioning

confidence: 99%

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Impact of surgical approach on 90-day mortality after lung resection for nonsmall cell lung cancer in high-risk operable patients

Etienne,

Pagès,

Iquille

et al. 2024

ERJ Open Res

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IntroductionNon-small cell lung cancer (NSCLC) is often associated with compromised lung function. Real world data on the impact of surgical approach in NSCLC patients with compromised lung function are still lacking. The objective of this study is to assess the potential impact of minimally invasive surgery (MIS) on 90-day post-operative mortality after anatomic lung resection in high-risk operable NSCLC patients.MethodsWe conducted a retrospective multicenter study including all patients who underwent anatomic lung resection between January 2010 and October 2021 and registered in the Epithor database. High-risk patients were defined as those with a FEV1 (forced expiratory volume in one second) or DLCO (diffusing lung capacity of carbon monoxide) value below 50%. Co-primary endpoints were the impact of risk status on 90-day mortality and the impact of MIS on 90-day mortality in high-risk patients.ResultsOf the 46.909 patients who met the inclusion criteria, 42.214 patients (90%) with both preoperative FEV1 and DLCO above 50% were included in the low-risk group, and 4695 patients (10%) with pre-operative FEV1 and/or pre-operative DLCO below 50% were included in the high-risk group. The 90-day mortality rate was significantly higher in the high-risk group compared to the low-risk group (280 [5.96%]versus1301 [3.18%];p<0.0001). In high-risk patients, minimally invasive surgery was associated with lower 90-day mortality compared to open surgery in univariate analysis (OR=0.04 [0.02–0.05], p<0.001) and in multivariable analysis after propensity score matching (OR=0.46 [0.30–0.69], p<0.001). High-risk patients operated through MIS had a similar 90-day mortality rate to low-risk patients in general (3.10%versus3.18% respectively).ConclusionIn examining the impact of surgical approaches on 90-day mortality using a nationwide database, we found that either preoperative FEV1 or DLCO below 50% is associated with higher 90-day mortality, which can be reduced by using minimally invasive surgical approaches. High-risk patients operated through minimally invasive surgery have a similar 90-day mortality rate as low-risk patients.

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Section: Methodsmentioning

confidence: 99%

“…All data came from the French registry Epithor managed by the French Society of Thoracic and Cardiovascular Surgery [ 6 ]. Created in 2002 under a specific authorisation by the National Commission of Information and Liberties (CNIL # 809833), this registry aims at collecting data from every patient who underwent thoracic surgery in France.…”

Section: Methodsmentioning

confidence: 99%

Impact of surgical approach on 90-day mortality after lung resection for nonsmall cell lung cancer in high-risk operable patients

Etienne,

Pagès,

Iquille

et al. 2024

ERJ Open Res

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“…Under the impulse of MD, former president of the French Society of Thoracic and Cardiovascular Surgery (SFCTCV), and thanks to its commitment a national database named EPITHOR ( 2 , 3 ) was created in 2003. Since this date, over 20,000 patients per year are recorded in the database and more than 90% of surgeons do fill the base.…”

Section: French National Databasementioning

confidence: 99%

Thoracic surgery in France

Gossot¹,

Saiydoun²,

Leclerc³

et al. 2022

J Thorac Dis

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Until recently, thoracic surgery in France was associated with vascular or cardiac surgery. It is now increasingly performed as a specific activity. Training of a thoracic surgeon has a common part with cardiovascular surgery during a 6-year curriculum including theory and practical practice acquired both by simulation and clinical fellowship. There are 343 board-certified surgeons performing thoracic surgery in 147 authorized centers. To be authorized to perform thoracic surgery, these centers must have at least 2 qualified surgeons and perform a minimum of 40 procedures per year for thoracic cancer. The discussion of the cases in a multidisciplinary tumor board (MDTB), validated by a written conclusion, is also mandatory and is a prerequisite for operating on patient for any cancer. All thoracic surgery procedures are recorded in a national database, Epithor. This database gives a precise idea not only of the activity but also of operative data, morbidity, mortality and follow-up. In 2023, participation to Epithor database will be a prerequisite for the certification of thoracic surgeons. Major changes in diagnostic and therapeutic options, development and innovations in video-assisted and robotically-assisted surgery, forthcoming transbronchial approaches will more likely lead to reorganize thoracic surgery with specialized and expert multidisciplinary boards as well as a concentration in high volume centers.

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