The impact of left lower paratracheal (4L) lymph node dissection on survival in patients with surgically treated left-sided NSCLC
| Autor: | Grzegorz M, Gryszko, Marcin M, Cackowski, Marcin, Zbytniewski, Katarzyna, Woźnica, Tadeusz M, Orłowski, Dariusz A, Dziedzic, Joanna, Nogaj |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Urology 030204 cardiovascular system & hematology Metastasis 03 medical and health sciences 0302 clinical medicine medicine Humans Clinical significance Prospective Studies Lung cancer Lymph node Neoplasm Staging Retrospective Studies business.industry Paratracheal lymph nodes Cancer General Medicine Prognosis medicine.disease medicine.anatomical_structure Lymphatic Metastasis 030220 oncology & carcinogenesis Propensity score matching Lymph Node Excision Surgery Lymphadenectomy Lymph Nodes Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 60:1201-1209 |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezab294 |
| Popis: | OBJECTIVES We aimed to investigate the clinical significance of left lower paratracheal nodes (#4L) and their impact on survival in patients with left-sided lung cancer. METHODS This was a retrospective analysis of prospective data. The study included 5369 patients who underwent surgery between 2005 and 2015. Six hundred fifty-nine patients underwent #4L dissection (4LND+), and 4710 did not (4LND−). Propensity score matching was used to minimize analytic error (659 vs 659). RESULTS The percentage of #4L metastasis increased with tumour size. Between pT2a and pT2b, it nearly doubled from 8% to 14%. The mean percentage of #4L metastasis in the pN2 group was 46, which was higher in left upper lobectomy compared to left lower lobectomy (63% vs 43%, respectively, P CONCLUSIONS Despite #4L nodes not being an independent prognostic factor in lung cancer, the percentage of nodal metastases notably increases above pT2a grade and is comparable to the percentage of #5 and #7 metastasis. Therefore, lymphadenectomy in advanced stages of cancer could benefit from resections of the #4L nodes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|