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Cosgun et al. Mini-invasive Surg 2019;3:32 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.024

Original Article Open Access

Factors on nodal up-staging in clinical N0
adenocarcinoma patients who had minimally

invasive anatomic lung resections

Tugba Cosgun , Erkan Kaba , Kemal Ayalp , Alper Toker 2
1
1
2
1 Department of Thoracic Surgery, Demiroglu Bilim University, Istanbul 34381, Turkey.
2 Department of Thoracic Surgery, Istanbul Florence Nightingale Hospital, Istanbul 34381, Turkey.
Correspondence to: Dr. Tugba Cosgun, Sisli Florence Nightingale Hospital, Merkez Mah, Abide-i Hurriyet Cd No:164, Sisli/
Istanbul 34387, Turkey. E-mail: tugba_cosgun@hotmail.com
How to cite this article: Cosgun T, Kaba E, Ayalp K, Toker A. Factors on nodal up-staging in clinical N0 adenocarcinoma patients who
had minimally invasive anatomic lung resections. Mini-invasive Surg 2019;3:32. http://dx.doi.org/10.20517/2574-1225.2019.024
Received: 17 Aug 2019 First Decision: 15 Oct 2019 Revised: 27 Oct 2019 Accepted: 5 Nov 2019 Published: 15 Nov 2019

Science Editor: Noriyoshi Sawabata Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract
Aim: The incidence of adenocarcinoma among lung cancer patients has increased in recent years. We identified
the factors affecting lymph node status in patients with primary lung adenocarcinoma who underwent minimally-
invasive anatomic resection.

Methods: We retrospectively analyzed the medical records of primary lung adenocarcinoma patients who underwent
minimally-invasive anatomic lung resections and mediastinal lymph node dissection between January 2012 and
December 2017. We evaluated lymph node positivity and nodal status in each T and histologic subgroup, tumoral
prognostic characteristics, minimally-invasive surgical methods and resection type.

Results: Of 473 patients who underwent anatomic resection for lung cancer between January 2012 and December
2017, 274 underwent minimally-invasive anatomic lung resections for primary lung cancer, 158 adenocarcinoma
patients were analyzed in this study. Nodal status and number of positive lymph nodes were similar in the stages T1,
T2, T3. Lymphovascular invasion (n : 78) and micropapillary predominance tended to be significant predisposing
factors for lymph node metastasis. Mean dissected lymph node number was significantly higher in patients who
underwent Robot-assisted thoracoscopic surgery compared to Video-assisted thoracoscopic surgery (P < 0.05),
and in those who underwent lobectomy compared to segmentectomy (P < 0.05).

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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