Radical systematic mediastinal lymphadenectomy versus mediastinal lymph node sampling in patients with clinical stage IA and pathological stage T1 non-small cell lung cancer |
| |
Authors: | Kai?Ma Dong?Chang Baoliang?He Min?Gong Feng?Tian Xiaodan?Hu Zhongyi?Ji Email author" target="_blank">Tianyou?WangEmail author |
| |
Institution: | (1) Department of Thoracic and Cardiovascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China;(2) Department of Thoracic Surgery, Qingdao Municiple Hospital, Qingdao, 266011, China |
| |
Abstract: | Purpose To explore the appropriate method of mediastinal lymph node dissection for selected clinical stage IA (cIA) non-small cell
lung cancer (NSCLC).
Methods From 1998 through 2002, the curative-intent surgery was performed to 105 patients with cIA NSCLC who had been postoperatively
identified as pathologic-stage T1. According to the method of intraoperative medistinal lymph node dissection, they were divided
into radical systematic mediastinal lymphadenectomy (LA) group (n = 42) and mediastinal lymph-node sampling (LS) group (n = 63). The effects of LS and LA on morbidity, N staging, overall survival (OS) and disease-free survival (DFS) were investigated.
Also, associations between clinicopathological parameters and survival were analyzed.
Results The mean numbers of dissected lymph nodes per patient in the LA group was significantly greater than that in the LS group
(15.59 ± 3.08 vs. 6.46 ± 2.21, P < 0.001), and the postoperative overall morbidity rate was higher in the LA group than that in the LS group (26.2 vs. 11.1%,
P = 0.045). There were no significant difference in migration of N staging, OS and DFS between two groups. However, for patients
with lesions between 2 and 3 cm, the 5-year OS in LA group was significantly higher than that in LS group (81.6 vs. 55.8%,
P = 0.041), and the 5-year DFS was also higher (77.9 vs. 52.5%, P = 0.038). For patients with lesions of 2 cm or less, 5-year OS and DFS were similar in both groups. Multivariate analysis
showed that lymph node metastasis was the unique unfavorable prognostic factor (P < 0.001).
Conclusions After being intraoperatively identified as stage T1, patients with lesions between 2 and 3 cm in cIA NSCLC should be performed
with LA to get a potentially better survival, and patients with lesions of 2 cm or less should be performed with LS to decrease
invasion. |
| |
Keywords: | Non-small cell lung cancer Clinical stage IA Mediastinal lymph node dissection Prognosis |
本文献已被 PubMed SpringerLink 等数据库收录! |
|