Nodal upstaging evaluation in NSCLC patients treated by robotic lobectomy

Zirafa, Carmelina Cristina; Aprile, Vittorio; Ricciardi, Sara; Romano, Gaetano; Davini, Federico; Cavaliere, Ilenia; Alì, Greta; Fontanini, Gabriella; Melfi, Franca

doi:10.1007/s00464-018-6288-8

Cited by 35 publications

(26 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“….34 in open group. In this study, the percentage of nodal upstaging in the two groups was similar, 20.8% by robotic surgery and 17.9% by open approach, confirming that lymphadenectomy by robotic approach can be precise, equalling open surgery [14] . Studies about oncologic outcomes after lung resection have confirmed the suitability in terms of oncologic radicality of resection of the robotic surgery for NSCLC treatment.…”

Section: Nodal Upstaging Evaluation In Robotic Surgery For Lung Cancersupporting

confidence: 67%

See 1 more Smart Citation

Nodal upstaging robotic lobectomy for non-small cell lung cancer

Zirafa¹,

Romano²,

Nesti³

et al. 2020

MIS

Self Cite

View full text Add to dashboard Cite

Nodal upstaging takes place when unsuspected lymph node metastases are detected by pathological evaluation, after surgical treatment for non-small cell lung cancer. In early stages non-small cell lung cancer, nodal upstaging amounts to 4.8%-24.6%, depending on several factors, such as accuracy of preoperative staging, localisation and size of tumour and number of lymph nodes removed. Nodal upstaging is considered a surrogate of the completeness of thoracic oncologic surgery; for this reason, various studies focus on the evaluation of its rate in the different surgical approaches used to treat lung cancer. In this analysis, a high percentage of upstaging is observed in robotic surgery, having similar values to open surgery results, usually considered the gold standard in terms of oncologic radicality. In fact, thanks to its features, robotic surgery allows carrying out a thorough lymphadenectomy in the most comfortable manner, ensuring an excellent vision and manoeuvrability of the instruments even in the most remote areas of the thorax. According to these results, robotic surgery constitutes a safe and radical surgical option, showing encouraging results on the efficacy of lymphadenectomy and, consequently, on its the long-term outcomes.

show abstract

Section: Nodal Upstaging Evaluation In Robotic Surgery For Lung Cancersupporting

confidence: 67%

“…Zirafa et al . [14] Thoracotomy is observed in about one-third of the patients after surgery. Rocha described a N2 upstaging in 8.3% of patients with preoperative negative nodes, investigated by mediastinoscopy [7] .…”

Section: Nodal Upstaging In Nsclcmentioning

confidence: 99%

Nodal upstaging robotic lobectomy for non-small cell lung cancer

Zirafa¹,

Romano²,

Nesti³

et al. 2020

MIS

Self Cite

View full text Add to dashboard Cite

show abstract

“…The five-year overall survival was not different between the two groups (48.6% and 48.7%, respectively, P = 0.76). With RATS, the rate of nodal upstaging was not different compared to open surgery, and higher than with VATS [20,21] .…”

Section: Lymph Node Dissection and Nodal Upstaging By Rats Vats Andmentioning

confidence: 74%

“…Length of hospital stay RR 0.77 (95%CI 0.54-1.09) P = 0.14 Shorter in RATS group P < 0.05 Table 1. Main reports concerning short-term outcomes after lobectomy performed by thoracotomy or a minimally invasive approach as VATS or RATS for a NSCLC in studies used for this article principles as anatomical dissection and allows better lymph node dissection [20,21] . The main limitations for the wide deployment of RATS are the higher cost of the procedure compared to VATS [22] and logistical issues.…”

Section: Complication Ratementioning

confidence: 99%

See 1 more Smart Citation

Robotic versus open and video-assisted thoracoscopic surgery approaches for lobectomy

Montagne¹,

Bottet²,

Sarsam³

et al. 2020

MIS

View full text Add to dashboard Cite

More and more data are available on the benefits of minimally invasive thoracic surgery compared to open thoracic surgery in the curative treatment of early-stage non-small cell lung cancer. However, results are conflicting, especially when video-assisted thoracoscopic surgery (VATS) is compared to robotic-assisted thoracoscopic surgery (RATS) for lobectomy. Our goal is to report the main results of recent systematic reviews and meta-analyses comparing RATS, VATS, and open surgery for lobectomy. Using PubMed database, we selected systematic reviews and meta-analyses, which compared the short-term outcomes of patients treated by RATS, VATS, or open surgery for lobectomy. In all but one of the systematic reviews, robotic lobectomy allowed similar short-term outcomes as VATS lobectomy and better short-term outcomes than open surgery. One meta-analysis by O'Sullivan et al. found that robotic lobectomy was associated with fewer adverse events (P < 0.00001) and lower 30-day mortality (P = 0.001), compared to VATS lobectomy. Robotic lobectomy could be a valid alternative to VATS and open lobectomy. Shortterm outcomes do not appear to be different between VATS and RATS cohorts, except in one recent meta-analysis, which reported the superiority of RATS compared to VATS. Without cost analysis and randomized controlled trials with long-term outcomes, no strong conclusions can be drawn.

show abstract

Perioperative outcomes of robot‐assisted vs video‐assisted and traditional open thoracic surgery for lung cancer: A systematic review and network meta‐analysis

Chen

Dai

et al. 2020

Robotics Computer Surgery

View full text Add to dashboard Cite

Background: The superiority of robot-assisted thoracic surgery (RATS) over videoassisted thoracic surgery (VATS) and thoracotomy remains controversial for lung cancer. Methods: A network meta-analysis (NMA) and pairwise meta-analysis (PMA) were performed to evaluate the perioperative outcomes using five databases. Results: Thirty-two studies involving 6593 patients were included for analysis. The NMA showed that RATS had similar operative time, conversion rate to thoracotomy, number of lymph node, postoperative morbidity, and length of hospital stay with VATS, except for lower 30-day mortality. Compared with thoracotomy, longer operative time and shorter hospital stay were observed in RATS, but no significant difference was observed in number of lymph node, postoperative morbidity, and 30-day mortality in both NMA and PMA. In lobectomy/segmentectomy subgroup, all outcomes, except for operative time of RATS vs VATS and number of lymph node, were similar with overall analyses. Conclusions: RATS had comparable perioperative outcomes with VATS and open surgery.

show abstract

Nodal upstaging evaluation in NSCLC patients treated by robotic lobectomy

Cited by 35 publications

References 28 publications

Nodal upstaging robotic lobectomy for non-small cell lung cancer

Nodal upstaging robotic lobectomy for non-small cell lung cancer

Robotic versus open and video-assisted thoracoscopic surgery approaches for lobectomy

Perioperative outcomes of robot‐assisted vs video‐assisted and traditional open thoracic surgery for lung cancer: A systematic review and network meta‐analysis

Contact Info

Product

Resources

About