Dataset Information

[The Argument and Consensus of Lymphadenectomy on Lung Cancer Surgery].

ABSTRACT: Lymph node metastasis is an important route of metastasis of lung cancer. Lymphadenectomy has become the standard surgical procedure for lung cancer. The way of intraoperative lymph node assessment also affects the prognosis and treatment strategy of lung cancer. In clinical practice, the way of intraoperative lymph node assessment ranges from selected lymph node biopsy to extended lymph node dissection. The advantages and disadvantages of different lymph node assessment are still controversial. In this article, the argument and consensus of lymphadenectomy on lung cancer operation are summarized.

SUBMITTER: Zhang L

PROVIDER: S-EPMC5973022 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Publications

[The Argument and Consensus of Lymphadenectomy on Lung Cancer Surgery].

Zhang Lanjun L

Zhongguo fei ai za zhi = Chinese journal of lung cancer 20180301 3

Lymph node metastasis is an important route of metastasis of lung cancer. Lymphadenectomy has become the standard surgical procedure for lung cancer. The way of intraoperative lymph node assessment also affects the prognosis and treatment strategy of lung cancer. In clinical practice, the way of intraoperative lymph node assessment ranges from selected lymph node biopsy to extended lymph node dissection. The advantages and disadvantages of different lymph node assessment are still controversial. ...[more]

PMID: 29587935

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Project description:BackgroundColorectal cancer (CRC) is a major cause of worldwide morbidity and mortality. Surgical treatment is common, and there is a great need to improve the delivery of such care. The gold standard for evaluating surgery is within well-designed randomized controlled trials (RCTs); however, the impact of RCTs is diminished by a lack of coordinated outcome measurement and reporting. A solution to these issues is to develop an agreed standard "core" set of outcomes to be measured in all trials to facilitate cross-study comparisons, meta-analysis, and minimize outcome reporting bias. This study defines a core outcome set for CRC surgery.Methods and findingsThe scope of this COS includes clinical effectiveness trials of surgical interventions for colorectal cancer. Excluded were nonsurgical oncological interventions. Potential outcomes of importance to patients and professionals were identified through systematic literature reviews and patient interviews. All outcomes were transcribed verbatim and categorized into domains by two independent researchers. This informed a questionnaire survey that asked stakeholders (patients and professionals) from United Kingdom CRC centers to rate the importance of each domain. Respondents were resurveyed following group feedback (Delphi methods). Outcomes rated as less important were discarded after each survey round according to predefined criteria, and remaining outcomes were considered at three consensus meetings; two involving international professionals and a separate one with patients. A modified nominal group technique was used to gain the final consensus. Data sources identified 1,216 outcomes of CRC surgery that informed a 91 domain questionnaire. First round questionnaires were returned from 63 out of 81 (78%) centers, including 90 professionals, and 97 out of 267 (35%) patients. Second round response rates were high for all stakeholders (>80%). Analysis of responses lead to 45 and 23 outcome domains being retained after the first and second surveys, respectively. Consensus meetings generated agreement on a 12 domain COS. This constituted five perioperative outcome domains (including anastomotic leak), four quality of life outcome domains (including fecal urgency and incontinence), and three oncological outcome domains (including long-term survival).ConclusionThis study used robust consensus methodology to develop a core outcome set for use in colorectal cancer surgical trials. It is now necessary to validate the use of this set in research practice.

Project description:BackgroundMinimally invasive total gastrectomy (MITG) is a mainstay for curative treatment of patients with gastric cancer. To define and standardize optimal surgical techniques and further improve clinical outcomes through the enhanced MITG surgical quality, there must be consensus on the key technical steps of lymphadenectomy and anastomosis creation, which is currently lacking. This study aimed to determine an expert consensus from an international panel regarding the technical aspects of the performance of MITG for oncological indications using the Delphi method.MethodsA 100-point scoping survey was created based on the deconstruction of MITG into its key technical steps through local and international expert opinion and literature evidence. An international expert panel comprising upper gastrointestinal and general surgeons participated in multiple rounds of a Delphi consensus. The panelists voted on the issues concerning importance, difficulty, or agreement using an online questionnaire. A priori consensus standard was set at > 80% for agreement to a statement. Internal consistency and reliability were evaluated using Cronbach's α.ResultsThirty expert upper gastrointestinal and general surgeons participated in three online Delphi rounds, generating a final consensus of 41 statements regarding MITG for gastric cancer. The consensus was gained from 22, 12, and 7 questions from Delphi rounds 1, 2, and 3, which were rephrased into the 41 statetments respectively. For lymphadenectomy and aspects of anastomosis creation, Cronbach's α for round 1 was 0.896 and 0.886, and for round 2 was 0.848 and 0.779, regarding difficulty or importance.ConclusionsThe Delphi consensus defined 41 steps as crucial for performing a high-quality MITG for oncological indications based on the standards of an international panel. The results of this consensus provide a platform for creating and validating surgical quality assessment tools designed to improve clinical outcomes and standardize surgical quality in MITG.

Dataset Information

[The Argument and Consensus of Lymphadenectomy on Lung Cancer Surgery].

Publications

[The Argument and Consensus of Lymphadenectomy on Lung Cancer Surgery].

Similar Datasets

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