Evidence map›Paper›PMID 39865313›Full record

ArticleJournal of cardiothoracic surgery2025

Propensity score matched comparison of lymph node upstaging in early-stage lung cancer: open versus minimally invasive surgery with standardized lymphadenectomy.

Julia Zimmermann, Julia Walter, Valentina Pfeiffer, Julia Kovács, Gökçe Yavuz, Johannes Schön, Mircea Gabriel Stoleriu, Christian Ketscher, Niels Reinmuth, Rudolf A Hatz and 2 more

Abstract readComparative Study
In one paragraph

Article in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Julia ZimmermannDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany. Julia.Zimmermann@med.uni-muenchen.de.
Julia WalterDepartment of Internal Medicine V, LMU University Hospital, LMU, Munich, Germany.
Valentina PfeifferDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.
Julia KovácsDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.
Gökçe YavuzDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.
Johannes SchönDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.
Mircea Gabriel StoleriuDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.
Christian KetscherDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.
Niels ReinmuthDepartment of Thoracic Oncology, Asklepios Lung Clinic, Gauting, Germany.
Rudolf A HatzDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.
Amanda TufmanDepartment of Internal Medicine V, LMU University Hospital, LMU, Munich, Germany.
Christian P SchneiderDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic, Gauting, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLymph node upstaging represents a quality criterion for standardized lymphadenectomy in lung cancer surgery. The aim of the study was to compare whether the quality of standardized lymphadenectomy in lung cancer surgery is comparable in minimally invasive (video-assisted thoracoscopic surgery) and the open approach (thoracotomy). Furthermore, factors associated with lymph node upstaging were assessed, as was its impact on overall survival and progression-free survival.

methodsThis retrospective study reviewed data of all patients undergoing lobectomy at the Lung Tumor Center Munich between 2011 and 2020. Inclusion factors were non-small cell lung cancer without nodal involvement (N0) or metastasis (M0) and standardized lymphadenectomy. A propensity score matched analyses was performed. Frequency of categorical outcomes was compared with Chi [2]-test, mean values with t-test. We used logistic and Cox regression models to assess factors associated with upstaging, overall survival and progression-free survival, restrictively.

resultsOf 1691 patients undergoing lobectomy, 637 met our inclusion criteria. After propensity score matching 198 patients remained in each group. Univariate analysis showed no significant difference in lymph node upstaging between the two groups. (p = 0.12). Overall affected lymph nodes (p = 0.45) and overall affected lymph node stations (p = 0.26) were not significantly different. Multivariate Cox regression analysis showed that overall survival and progression free survival were also independent of the surgical approach. L1 status was the only factor associated with progression-free survival.

conclusionMinimally invasive approaches achieves comparable lymph node upstaging in patients undergone standardized lymphadenectomy.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsLymph Node ExcisionLymph NodesMinimally Invasive Surgical ProceduresPneumonectomyPropensity ScoreThoracic Surgery, Video-AssistedThoracotomyAgedFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm StagingLymphadenectomyNon-small cell lung cancerPropensity score matchingSurvivalThoracotomyTumor stagingVideo-assisted thoracoscopic surgery

Identifiers

PMID39865313
PMCPMC11770911

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.