A Society of Thoracic Surgeons General Thoracic Surgery Database analysis of the association between lymph node dissection and chylothorax.
2/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
환자: chylothorax were younger, had fewer comorbidities, a higher frequency of right-sided tumors(78
I · Intervention 중재 / 시술
elective lung resection for stage I-III non-small cell lung cancer January 2015 -December 2024 (n=152,823)
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSIONS] Chylothorax risk increases with number of lymph nodes dissected, and it is associated with a dramatic increase in morbidity but not mortality. This underscores the importance of balancing the oncologic benefit of extensive LN dissection in patients with low-grade cancers against the risks it poses, including chylothorax.
OpenAlex 토픽 ·
Lymphatic Disorders and Treatments
Pleural and Pulmonary Diseases
Lymphatic System and Diseases
[BACKGROUND] Guideline-concordant lymph node (LN) dissection may increase chylothorax risk following lung resection.
- 표본수 (n) 152,823
- p-value p<0.001
- 95% CI 1.13-19.63
APA
Devanish N. Kamtam, Levi Bonnell, et al. (2026). A Society of Thoracic Surgeons General Thoracic Surgery Database analysis of the association between lymph node dissection and chylothorax.. The Annals of thoracic surgery. https://doi.org/10.1016/j.athoracsur.2026.04.013
MLA
Devanish N. Kamtam, et al.. "A Society of Thoracic Surgeons General Thoracic Surgery Database analysis of the association between lymph node dissection and chylothorax.." The Annals of thoracic surgery, 2026.
PMID
42034239
Abstract
[BACKGROUND] Guideline-concordant lymph node (LN) dissection may increase chylothorax risk following lung resection. We analyzed predictors of chylothorax, with a focus on the extent and pattern of LN dissection, using the Society of Thoracic Surgeons General Thoracic Surgery Database (STS-GTSD).
[METHODS] We studied patients who underwent elective lung resection for stage I-III non-small cell lung cancer January 2015 -December 2024 (n=152,823). The primary endpoint was 30-day postoperative chylothorax. Independent predictors of chylothorax were identified using multivariable logistic regression. A sensitivity analysis assessed nodal stations and chylothorax using contemporary data (2021-present).
[RESULTS] The overall incidence of chylothorax was 0.73%(n=1,110). Patients with chylothorax were younger, had fewer comorbidities, a higher frequency of right-sided tumors(78.4% vs. 60.9%) and more advanced disease. The median number of lymph nodes dissected was higher in the chylothorax group [14(IQR:9-21) vs. 10(IQR:6-16)]. The strongest independent predictors of chylothorax included the number of sampled lymph nodes, cT4(aOR:4.72, 95%CI:1.13-19.63), right-sided tumor(aOR:2.17, 95%CI:1.83-2.59), dialysis(aOR:2.15, 95%CI:1.49-3.11), and open surgical approach(aOR:1.59, 95%CI:1.34-1.88). Sensitivity analyses confirmed these findings and identified 2R sampling as an additional independent predictor(aOR:1.27, 95%CI:1.02-1.57). Chylothorax was associated with higher rate of major morbidity(35.7% vs. 6.6%, p<0.001) but not increased mortality(1.4% vs. 1.0%, p=0.17).
[CONCLUSIONS] Chylothorax risk increases with number of lymph nodes dissected, and it is associated with a dramatic increase in morbidity but not mortality. This underscores the importance of balancing the oncologic benefit of extensive LN dissection in patients with low-grade cancers against the risks it poses, including chylothorax.
[METHODS] We studied patients who underwent elective lung resection for stage I-III non-small cell lung cancer January 2015 -December 2024 (n=152,823). The primary endpoint was 30-day postoperative chylothorax. Independent predictors of chylothorax were identified using multivariable logistic regression. A sensitivity analysis assessed nodal stations and chylothorax using contemporary data (2021-present).
[RESULTS] The overall incidence of chylothorax was 0.73%(n=1,110). Patients with chylothorax were younger, had fewer comorbidities, a higher frequency of right-sided tumors(78.4% vs. 60.9%) and more advanced disease. The median number of lymph nodes dissected was higher in the chylothorax group [14(IQR:9-21) vs. 10(IQR:6-16)]. The strongest independent predictors of chylothorax included the number of sampled lymph nodes, cT4(aOR:4.72, 95%CI:1.13-19.63), right-sided tumor(aOR:2.17, 95%CI:1.83-2.59), dialysis(aOR:2.15, 95%CI:1.49-3.11), and open surgical approach(aOR:1.59, 95%CI:1.34-1.88). Sensitivity analyses confirmed these findings and identified 2R sampling as an additional independent predictor(aOR:1.27, 95%CI:1.02-1.57). Chylothorax was associated with higher rate of major morbidity(35.7% vs. 6.6%, p<0.001) but not increased mortality(1.4% vs. 1.0%, p=0.17).
[CONCLUSIONS] Chylothorax risk increases with number of lymph nodes dissected, and it is associated with a dramatic increase in morbidity but not mortality. This underscores the importance of balancing the oncologic benefit of extensive LN dissection in patients with low-grade cancers against the risks it poses, including chylothorax.