Prognostic Impact of Lymphadenectomy on Outcomes of Sublobar Resection for Non-small Cell Lung Cancer ≤1 or >1 to 2 Cm

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2020 Jul 10

PMID 32642107

Citations 2

Authors

Enkuo Zheng

Minglei Yang

Rui Li

Junjun Ni

Xiang Xu

Guofang Zhao

Affiliations

Soon will be listed here.

Abstract

Background: Lymphadenectomy is an important part of surgical treatment for non-small cell lung cancer (NSCLC). However, the prognostic impact of lymph node (LN) dissection for patients with NSCLC ≤1 and >1 to 2 cm who underwent sublobar resection is still unclear.

Methods: A group of patients numbering 7,627 with NSCLC 2 cm or less who underwent sublobar resection were identified from the Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and November 2015. The overall survival (OS) and lung cancer-specific survival (LCSS) were evaluated among patients who had undergone dissection of ≥4 LNs, 1 to 3 LNs or who had no-LN dissection; log-rank and Cox proportional-hazards regression analyses were used for the evaluation.

Results: Patients with NSCLC ≤2 cm who underwent ≥4 LNs dissection had better OS and LCSS compared with those who underwent dissection of 1 to 3 LNs or who had no-LN dissection after sublobar resection. Subgroup analysis showed that dissection of ≥4 LNs had better OS and LCSS than those of 1 to 3 LNs dissection in NSCLC >1 to 2 cm, whereas had similar OS and LCSS in NSCLC ≤1 cm. Multivariate Cox analysis showed that dissection of 1 to 3 LNs was not an independent risk factor of OS and LCSS than dissection of ≥4 LNs in NSCLC ≤1 cm after sublobar resection.

Conclusions: The extent of LN dissection is associated with the survival outcomes in patients with NSCLC ≤2 cm after sublobar resection. Dissection of ≥4 LNs should be recommended for NSCLC >1 to 2 cm, whereas surgeons can rely on surgical skills and patient profiles to decide ≥4 LNs or 1 to 3 LNs dissection for NSCLC ≤1 cm during sublobar resection.

Citing Articles

Impact of the number of dissected lymph nodes on machine learning-based prediction of postoperative lung cancer recurrence: a single-hospital retrospective cohort study.

Kojima K, Samejima H, Okishio K, Tokunaga T, Yoon H, Atagi S BMJ Open Respir Res. 2024; 11(1).

PMID: 39327061 PMC: 11429344. DOI: 10.1136/bmjresp-2023-001926.

Outcomes of sublobar resection vs lobectomy for invasive clinical stage T1N0 non-small-cell lung cancer: A propensity-match analysis.

Wald O, Sadeh B, Bdolah-Abram T, Erez E, Shapira O, Izhar U Cancer Rep (Hoboken). 2021; 4(3):e1339.

PMID: 33570255 PMC: 8222555. DOI: 10.1002/cnr2.1339.

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