Does surgeon experience affect outcomes in pathologic stage I lung cancer?

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Surgeon experience is a critical factor in surgical outcomes.
• Optimal experience levels for non-small cell lung cancer (NSCLC) resection are not well-defined.

Purpose of the Study:

• To assess the impact of surgeon experience on perioperative and long-term outcomes in early-stage non-small cell lung cancer (NSCLC).

Main Methods:

• Retrospective analysis of 800 patients with pathologic stage I NSCLC (2000-2012).
• Surgeons categorized into low (<5 years), moderate (5-15 years), and high (>15 years) experience groups.
• Outcomes analyzed included perioperative morbidity, video-assisted thoracoscopic surgery (VATS) use, lymph node sampling, and 5-year overall survival.

Main Results:

• Perioperative morbidity was similar across all experience groups (30.3% low, 22.8% moderate, 28.9% high).
• Moderate experience surgeons utilized VATS more frequently and sampled more mediastinal lymph node stations.
• Five-year overall survival was significantly higher in the moderate experience group (76.9%) compared to low (67.5%) and high (71.4%) experience groups.

Conclusions:

• Surgeon experience does not influence perioperative outcomes in early-stage NSCLC resection.
• Moderate surgical experience (5-15 years post-fellowship) is associated with improved long-term survival for NSCLC patients.