2023 World Conference on Lung Cancer (Posters)-P1.25. Adequacy of Mediastinal Lymph Node Dissection in the Setting of New NCCN Guidelines: Simplified Method From A Rural Hospital

P1.25. Adequacy of Mediastinal Lymph Node Dissection in the Setting of New NCCN Guidelines: Simplified Method From A Rural Hospital - PDF(Abstract)

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This study investigates the adequacy of mediastinal lymph node dissection in the context of the 2021 National Comprehensive Cancer Network (NCCN) guidelines for non-small cell lung cancer. The previous guidelines recommended sampling at least ten mediastinal lymph nodes, while the revised guidelines recommend obtaining at least three N2 stations and one N1 station lymph nodes. The researchers implemented a non-commercial tool and a "triple-check" system in a small rural hospital to improve lymph node sampling. <br /><br />The study conducted a retrospective review of video-assisted thoracoscopic surgeries (VATS) performed at a rural hospital in Western Massachusetts between May 2019 and February 2023. The tool used in the operating room listed specific lymph node stations for right and left-sided lung resections, and each station had to be crossed out after being obtained. The "triple-check" system involved shared responsibility among the surgeon, surgical scrub techs, and circulating nurses regarding the collection of all required lymph node stations. The data collected included pathology reports and operative reports.<br /><br />The analysis included 136 cases, with 67 cases performed before the tool and system implementation and 69 cases performed after. The primary outcome of the analysis was the mean number of N1 and N2 lymph node stations obtained before and after the tool implementation. There was a statistically significant increase in the number of lymph node stations sampled after the introduction of the tool. The total number of lymph nodes sampled also significantly increased with the tool's introduction. <br /><br />The study concludes that implementing a simple, non-commercial tool and triple-check system for collecting lymph nodes during VATS can significantly improve adherence to the NCCN guidelines without the costs of pre-packaged kits. Adhering to the guidelines allows for appropriate staging and escalation of therapy, leading to better prognosis. However, larger studies are needed to establish statistical significance.

Asset Subtitle

Kevin Kennedy

Meta Tag

Speaker Kevin Kennedy

Topic Early-Stage NSCLC: Changing Paradigms & Outcomes

Keywords

mediastinal lymph node dissection

2021 National Comprehensive Cancer Network guidelines

non-small cell lung cancer

lymph node sampling

video-assisted thoracoscopic surgeries

rural hospital

tool implementation

triple-check system

lymph node stations

adherence to guidelines