An Evaluation of Lymph Node Harvest in Sublobar Resections in a Statewide Quality Collaborative.

Objective: Evaluate the effectiveness of nodal harvest in sublobar resections (SLR) for peripheral non-small cell lung cancer (NSCLC).

Methods: Retrospective review of prospectively collected data for patients who underwent wedge resection (WR) and segmentectomy (SG) for NSCLC from January 2015 to March 2023 at 21 centers within a statewide quality collaborative. The primary end point was the extent of lymph node (LN) harvest defined as ≥ 10 LNs, ≥5 lymph node stations (LNS), or 3 mediastinal LNS and 1 hilar LNS (3/1 LNS). We also examined the LN harvest stratified by operative approach (open, video-assisted (VATS), robot-assisted (RATS)).

Results: A total of 1398 patients receiving SLR were reviewed: 919 (65.7%) with WR and 479 (34.3%) with SG. Only 15.6% (152) WR and 54.6% (263) SG had an adequate number of LNS harvested. RATS was associated with higher rates of harvesting ≥10 LNs (p < .001) or harvesting ≥5 LNS or 3/1 LNS (p < .001) compared with VATS for WR. Compared with open procedures and VATS, RATS was associated with higher rates of harvesting ≥5 LNS or 3/1 LNS for SG (p = 0.002; p = 0.003, respectively).

Conclusion: WR and SG have low rates of adequate LN harvesting. Robotic surgery was associated with improved LN harvesting rates. Given the increase interest in SLRs, continued focus on improving and increasing LN harvesting are needed.