Spanish Video-Assisted Thoracic Surgery Group: Method, Auditing, and Initial Results From a National Prospective Cohort of Patients Receiving Anatomical Lung Resections

Embún, Raul; Royo-Crespo, Iñigo; Díaz, José Luis Recuero; Bolufer, Sergio; Call, Sergi; Congregado, Miguel; Antonio, David Gómez-de; Jiménez, Marcelo F.; Moreno-Mata, Nicolás; Aguinagalde, Borja; Amor-Alonso, Sergio; Arrarás, Miguel Jesús; Orozco, Ana Isabel Blanco; Boada, Marc; Cabañero-Sánchez, Alberto; Breda-Vázquez, Isabel; Ramos, Ángel Cilleruelo; Carrasco, Susana; Fernández-Martín, Elena; García-Barajas, Santiago; García-Jiménez, María Dolores; Prim, Jose Maria Garcia; Garcia-Salcedo, Jose Alberto; Gelbenzu-Zazpe, Juan José; Giraldo-Ospina, Carlos Fernando; Hernández, María Teresa Gómez; Hernández, Jorge; Wolf, Jennifer D. Illana; Abularach, Alberto Jauregui; Jiménez, Unai; Sanz, Iker López; Martínez-Hernández, Néstor J.; Martínez-Téllez, Elisabeth; Collado, Lucía Milla; Poce, Roberto Mongil; Moradiellos-Díez, Francisco Javier; Moreno-Balsalobre, Ramón; Merino, Sergio B. Moreno; Obiols, Carme; Valenzuela, Florencio Quero; Ramírez-Gil, María Elena; Ramos-Izquierdo, Ricard; Rivo, Eduardo; Rodríguez-Fuster, Alberto; Rojo-Marcos, Rafael; Sánchez-Lorente, David; Moreno, Laura; Simón, Carlos; Trancho, Florentino Hernando

doi:10.1016/j.arbr.2020.01.009

Cited by 3 publications

(6 citation statements)

References 24 publications

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“…In 2016, the Spanish Society of Thoracic Surgery developed a prospective multicentric database with the participation of 33 certified Spanish thoracic surgery centers, all of them members of the Spanish Video-assisted Thoracic Surgery Group. 14 This project was approved by the ethics committees of all the participating centers, and informed consent was obtained from the recruited patients to use their clinical data for scientific purposes (PI15/0072, 20/05/2015). Each center included all consecutive patients undergoing VATS anatomic lung resections from December 20, 2016, to March 20, 2018.…”

Section: Methodsmentioning

confidence: 99%

Thoracoscopic segmentectomy versus lobectomy: A propensity score–matched analysis

et al. 2022

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Section: Methodsmentioning

confidence: 99%

Thoracoscopic segmentectomy versus lobectomy: A propensity score–matched analysis

et al. 2022

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“…However, since a significant number of patients die after discharge within 90 days after pulmonary resection as a consequence of any surgical related complication ( 25 ), it can be considered that FTR based on 90-day mortality could be a better indicator of postoperative surgical care. Second, our data are based on a multicentre voluntary registry, so that, although the details of the data audit have been previously reported ( 12 ), bias related to patient selection and quality of data could have influenced our findings. Furthermore, our results should be confirmed in additional patient cohorts from different multi-institutional databases.…”

Section: Discussionmentioning

confidence: 99%

“…The Spanish Group of Video-Thoracoscopic Surgery (GEVATS) project ( 12 ) was approved by the ethics committees of all the participating centres and informed consent was obtained from the recruited patients to use their clinical data for scientific purposes (Approval by Ethics Committee of Aragon Health Research Institute on 20 May 2015 PI15/0072). This specific study was evaluated and approved by the scientific committee of GEVATS.…”

Section: Methodsmentioning

confidence: 99%

Failure to rescue following anatomical lung resection. Analysis of a prospective nationwide database

Gómez-Hernández

Rivas²,

Novoa³

et al. 2023

Front. Surg.

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BackgroundRescue failure has been described as an important factor that conditions postoperative mortality after surgical interventions. The objective of this study is to determine the incidence and main determinants of failure to rescue after anatomical lung resections.MethodsProspective multicenter study that included all patients undergoing anatomical pulmonary resection between December 2016 and March 2018 and registered in the Spanish nationwide database GEVATS. Postoperative complications were classified as minor (grades I and II) and major (grades IIIa to V) according to the Clavien-Dindo standardized classification. Patients that died after a major complication were considered rescue failure. A stepwise logistic regression model was created to identify predictors of failure to rescue.Results3,533 patients were analyzed. In total, 361 cases (10.2%) had major complications, of which 59 (16.3%) could not be rescued. The variables associated with rescue failure were: ppoDLCO% (OR, 0.98; 95% CI, 0.96–1; p = 0.067), cardiac comorbidity (OR, 2.1; 95% CI, 1.1–4; p = 0.024), extended resection (OR, 2.26; 95% CI, 0.94–5.41; p = 0.067), pneumonectomy (OR, 2.53; 95 CI, 1.07–6.03; p = 0.036) and hospital volume <120 cases per year (OR, 2.53; CI 95%, 1.26–5.07; p = 0.009). The area under the curve of the ROC curve was 0.72 (95% CI: 0.64–0.79).ConclusionA significant percentage of patients who presented major complications after anatomical lung resection did not survive to discharge. Pneumonectomy and annual surgical volume are the risk factors most closely related to rescue failure. Complex thoracic surgical pathology should be concentrated in high-volume centers to obtain the best results in potentially high-risk patients.

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“…A multicentre prospective cohort study was designed to include all anatomical lung resections performed in the 33 Spanish centres; which lasted for over a 15-month period (20 December 2016–20 March 2018). Further details of the database characteristics, auditing methods, and variables included are available elsewhere ( 14 ).…”

Section: Methodsmentioning

confidence: 99%

“…We conducted a real-world study to assess the impact of avoiding the invasive procedures recommended by the guidelines on rates of unexpected pN2 and long-term survival in surgical lung cancer with data obtained from the prospective cohort of the Spanish Group for Video-Assisted Thoracic Surgery (GEVATS) of the Spanish Society of Thoracic Surgery (SECT) ( 14 ). This manuscript is written following the STROBE reporting checklist (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1900/rc ).…”

Section: Introductionmentioning

confidence: 99%

Presurgical invasive mediastinal staging in lung cancer, unexpected N2 and long-term survival: a registry-based study with data from the Spanish group for video-assisted thoracic surgery

López,

Aguinagalde,

Urreta

et al. 2024

J Thorac Dis

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Background Mediastinal lymph node staging is a key element in the diagnosis of lung cancer. The combination of computed tomography (CT) and positron emission tomography (PET) has improved staging but some circumstances are known to influence their negative predictive value. The objective of this study was to assess the impact on survival of avoiding invasive mediastinal staging in surgical lung cancer patients with negative mediastinum in CT and PET and intermediate risk of unexpected pN2. Methods Data were collected from the prospective cohort of the Spanish Group for Video-Assisted Thoracic Surgery (GEVATS), from December 2016 to March 2018. For this study, patients were selected if they had negative mediastinum in CT and PET findings but tumours >3 cm or located centrally, or with cN1 disease. Patients who did and did not undergo invasive staging [invasive group (IG) and non-invasive group (NIG)] were compared, analysing unexpected pN2 and survival with Kaplan-Meier curves and Cox regression. Results A total of 2,826 patients underwent surgery for primary lung cancer. We selected 1,247 patients who had tumours >3 cm, central tumours or cN1. Invasive staging was performed in 275 (22.1%) cases. The unexpected pN2 rate was 9.6% in the NIG and 13.8% in the IG, but half of them were discovered prior to surgery in the IG. Five-year overall survival (OS) was poorer in the IG (52.4% vs . 64%; P<0.001). In the Cox regression model, male sex, older age, diabetes, synchronous tumour, lower diffusing capacity for carbon monoxide, larger tumour size, higher pathological N-stage, and IG status were significant independent risk factors. Conclusions Invasive staging recommended by guidelines could be reduced with an appropriate selection in mediastinal CT- and PET-negative patients with risk factors for unexpected pN2, because rates of pN2 and survival did not worsen without invasive staging.

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Spanish Video-Assisted Thoracic Surgery Group: Method, Auditing, and Initial Results From a National Prospective Cohort of Patients Receiving Anatomical Lung Resections

Cited by 3 publications

References 24 publications

Thoracoscopic segmentectomy versus lobectomy: A propensity score–matched analysis

Thoracoscopic segmentectomy versus lobectomy: A propensity score–matched analysis

Failure to rescue following anatomical lung resection. Analysis of a prospective nationwide database

Presurgical invasive mediastinal staging in lung cancer, unexpected N2 and long-term survival: a registry-based study with data from the Spanish group for video-assisted thoracic surgery

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