PhotoNodes protocol: a multicenter prospective study for the assessment of proper lymphadenectomy in minimally-invasive gastric cancer surgery using intraoperative photographs.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2025-04-22 DOI:10.1159/000545846

Federico Marchesi, Marina Valente, Simone Giacopuzzi, Gian Luca Baiocchi, Paolo Morgagni, Lorena Torroni, Giorgio Dalmonte

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引用次数: 0

Abstract

Introduction: In gastric cancer surgery an adequate D2 lymphadenectomy is associated with improved cancer specific survival. The aim of this study is to test the reliability of a new score (Photonodes score - PNS) conceived to rate the quality of lymphadenectomy in minimally-invasive gastrectomy. The primary outcome of the study is to assess the inter-observer agreement among the reviewers assigning the score. The secondary outcome is the association between PNS and survival.

Methods: This is a multicentric observational prospective study enrolling patients undergoing minimally-invasive gastrectomy for gastric cancer with D2 lymphadenectomy. A set of laparoscopic/robotic images will be collected from each patient. Based on each set of images, the quality of lymphadenectomy performed will be rated with the new PNS by three surgeons. Fleiss' Kappa measure of agreement will be used to study the rating agreement among examining surgeons. The PNS score will correlate with disease-free and overall survival.

Conclusion: The spread of minimally invasive approaches in oncologic gastric surgery made the collection of intraoperative images easier; for this reason we believe that PNS could represent a new and efficient tool to assess the quality of D2 lymphadenectomy in clinical practice. The PhotoNodes study was registered at ClinicalTrials.gov #NCT06466902.

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PhotoNodes方案：一项使用术中照片评估微创胃癌手术中适当淋巴结切除术的多中心前瞻性研究。

导言：在胃癌手术中，适当的D2淋巴结切除术与提高癌症特异性生存率相关。本研究的目的是测试一种新的评分（Photonodes评分- PNS）的可靠性，该评分被设想用于评价微创胃切除术中淋巴结切除术的质量。本研究的主要结果是评估评分者之间的观察者之间的一致性。次要结局是PNS与生存之间的关系。方法：这是一项多中心观察性前瞻性研究，纳入了行微创胃切除术并D2淋巴结切除术的胃癌患者。将从每位患者收集一组腹腔镜/机器人图像。根据每组图像，三名外科医生将用新的PNS对淋巴结切除术的质量进行评估。Fleiss的Kappa一致性度量将用于研究检查外科医生之间的评级一致性。PNS评分将与无病生存和总生存相关。结论：微创入路在胃肿瘤手术中的广泛应用，使术中影像的采集更加容易；因此，我们认为PNS在临床实践中可以作为评估D2淋巴结切除术质量的一种新的有效工具。PhotoNodes研究已在ClinicalTrials.gov注册，注册号为NCT06466902。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.