Factors Associated With Margin Positivity After Lung Resection Surgery.
Publication/Presentation Date
9-1-2024
Abstract
INTRODUCTION: The purpose of this study is to utilize a representative national sample to investigate the factors associated with margin positivity after attempted surgical resection. Given the changes in surgical approaches to lung cancer for the last 10 years, margin positivity and outcomes between robotic, video assisted thoracoscopic surgery (VATS) and open surgical resections may vary.
METHODS: This retrospective cohort study utilized the National Cancer Database. Patients with non-small-cell lung cancer, 18 or older and who had a surgical lung resection between 2010 and 2019 were included. Demographic data, along with patient-level clinical variables were extracted. Patient-level outcome variables including 30-day, 90-day mortality and readmission rates were analyzed. Univariable and multivariable logistic regression was utilized to assess factors associated with margin positivity.
RESULTS: A total of 226,884 patients were identified. Of the total cohort, 9229 had positive margins (4.2%). Patients with positive margins had statistically significant increased 30-day, 90-day mortality, as well as increased readmission rate. Older age, male sex, patients undergoing an open resection, patients who underwent a wedge resection, higher clinical stage, larger tumor size, squamous and adenosquamous histologies, and higher Charlson-Deyo Comorbidity Index were all associated with having a positive margin after resection.
CONCLUSION: In conclusion, there was no difference in margin positivity when comparing robotic and VATS resection, however, open resection had increased rates of margin positivity. Increasing tumor size, clinical stage, squamous and adenosquamous histologies, male sex, and patients undergoing a wedge resection were all associated with increased rates of margin positivity.
Volume
25
Issue
6
First Page
560
Last Page
566
ISSN
1938-0690
Published In/Presented At
Rshaidat, H., Whitehorn, G. L., Collins, M., Mack, S. J., Martin, J., Grenda, T. R., Evans, N. R., 3rd, & Okusanya, O. T. (2024). Factors Associated With Margin Positivity After Lung Resection Surgery. Clinical lung cancer, 25(6), 560–566. https://doi.org/10.1016/j.cllc.2024.03.007
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
38658271
Department(s)
Administration and Leadership
Document Type
Article