The new TNM classification of lung cancer in practice

Background: Nowadays, video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS) are known to be safe and efficient surgical procedures to treat early-stage non-small cell lung cancer (NSCLC). We assessed whether RATS increased disease-free survival (DFS) compared with VATS for lobectomy and segmentectomy. Methods: This retrospective cohort study included patients treated for resectable NSCLC performed by RATS or VATS, in our tertiary care center from 2012 to 2019. Patients’ data were prospectively recorded and reviewed in the French EPITHOR database. Primary outcomes were 5-year DFS for lobectomy and 3-year DFS for segmentectomy, compared by propensity-score adjusted difference of Kaplan–Meier estimates. Results: Among 844 lung resections, 436 VATS and 234 RATS lobectomies and 46 VATS and 128 RATS segmentectomies were performed. For lobectomy, the adjusted 5-year DFS was 60.9% (95% confidence interval (CI) 52.9–68.8%) for VATS and 52.7% (95%CI 41.7–63.7%) for RATS, with a difference estimated at −8.3% (−22.2–+4.9%, p = 0.24). For segmentectomy, the adjusted 3-year DFS was 84.6% (95%CI 69.8–99.0%) for VATS and 72.9% (95%CI 50.6–92.4%) for RATS, with a difference estimated at −11.7% (−38.7–+7.8%, p = 0.21). Conclusions: RATS failed to show its superiority over VATS for resectable NSCLC.

show abstract

“…For consistency of TNM stage between patients, we used the 7th Ed. of lung cancer TNM [ 37 ]. We converted the 8th Ed.…”

Section: Methodsmentioning

confidence: 99%

Long-Term Survival Following Minimally Invasive Lung Cancer Surgery: Comparing Robotic-Assisted and Video-Assisted Surgery

Montagne

Chaari

Bottet

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…The NKR is a population-based cancer registry in which trained registry personnel actively collect data from medical records on patient characteristics, such as gender, date of birth, and tumor characteristics, such as the date of diagnosis, tumor type, subsite (according to International Classification of Diseases for Oncology), histologic type, tumor grade, and initial treatment. Stage is recorded according to the Tumor Node Metastasis classification (2010-2016: seventh edition, 21 2017: eighth edition 22 ). The NKR is maintained by the Netherlands Comprehensive Cancer Organization (Integraal Kankercentrum Nederland, IKNL).…”

Section: Methodsmentioning

confidence: 99%

Evaluating Cancer Care Networks; A Case Study of a Lung Cancer Care Network

Wind

Bretveld

Schijndel³

et al. 2021

Int J Health Policy Manag

View full text Add to dashboard Cite

Background: Networks are promoted as an organizational form that enables integrated care as well as enhanced patient outcomes. However, implementing networks is complex. It is therefore important to evaluate the quality and effectiveness of networks to ensure it is worth developing and maintaining them. This article describes the development of an evaluation tool for cancer care networks and the results of a pilot study with a regional lung cancer care network. Methods: This study used a combination of qualitative and quantitative evaluation methods. The qualitative evaluation was based on a framework with 10 standards for the organization of an oncological (tumor-specific) care network. Data for the quantitative evaluation were obtained from the Dutch Cancer Registry. The evaluation was performed at a network of three hospitals collaborating in the field of lung oncology. Results: The qualitative evaluation framework consisted of 10 standards/questions which were divided into 38 sub-questions. The evaluation showed that in general patients are satisfied with the collaboration in the network. However, some improvement points were found such as the need for more attention for the implementation and periodic evaluation of a regional care pathway. The start of a regional multidisciplinary meeting has been a major step for improving the collaboration. Conclusion: An evaluation tool for (lung) cancer care networks was successfully developed and piloted within a cancer care network. The tool has proven to be a useful method for evaluating collaboration within an oncological network. It helped network partners to understand what they see as important and allowed them to learn about their program’s dynamics. Improvement opportunities were successfully identified. To keep the tool up to date continuous improvement is needed, following the Plan Do Check Act (PDCA) cycle.

show abstract

“…Endobronchial tumor in which its main component is endoluminal and present in the proximal main or lobar bronchi and proved to be Non-Small Cell Lung Carcinoma (NSCLC) by histopathological examination of stage IIIA or IIIB according to the AJCC staging [2].…”

Section: Inclusion Criteriamentioning

confidence: 99%