Lobe-specific Lymph Node Dissection in Clinical Stage IA Solid-dominant Non–small-cell Lung Cancer: A Propensity Score Matching Study
| Autor: | Zhirong Zhang, Feng Li, Lin Yang, Ligong Yuan, Yue Zhao, Qi Xue, Shugeng Gao, Ningning Ding, Jie He, Yushun Gao, Fengwei Tan, Jun Zhao, Shuaibo Wang, Yousheng Mao, Dali Wang |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine Pulmonary and Respiratory Medicine Cancer Research medicine.medical_specialty Lung Neoplasms Disease-Free Survival 03 medical and health sciences Postoperative Complications 0302 clinical medicine Recurrence Carcinoma Non-Small-Cell Lung medicine Humans Minimally Invasive Surgical Procedures Prospective Studies Stage (cooking) Pneumonectomy Propensity Score Lung cancer Lymph node Aged Neoplasm Staging business.industry Incidence (epidemiology) Perioperative Middle Aged medicine.disease Surgery Survival Rate Dissection 030104 developmental biology medicine.anatomical_structure Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Propensity score matching Lymph Node Excision Complication business |
| Zdroj: | Clinical Lung Cancer. 22:e201-e210 |
| ISSN: | 1525-7304 |
| Popis: | Background Lobectomy with systematic lymph node dissection (SND) remains the standard procedure for resectable non–small-cell lung cancer (NSCLC), whereas lobe-specific lymph node dissection (LSND) was reported to have more advantages in perioperative recovery and complication reduction in treating early-stage diseases. Survival outcomes after LSND remains controversial compared with SND. Patients and Methods From 2014 to 2017, data of 546 patients with clinical stage IA solid-dominant NSCLC and who underwent curative lobectomies with LSND (n = 100) or SND (n = 446) at our institution were collected. Propensity score matching was conducted to eliminate the biases. Five-year disease-free survival and overall survival were compared between the groups. Perioperative parameters and postoperative complications were also analyzed. Results Lobectomies with LSND or SND were performed in 100 patients and 446 patients, respectively. After matching, there were 100 patients in each group and no significant differences in 5-year overall survival (P = .473) and disease-free survival (P = .789) were found between the groups. Recurrence patterns were also similar (P = .733). Perioperative parameters were similar, whereas the incidence of postoperative complications in the SND group was found to be significantly higher than that in the LSND group (P = .003). Conclusions Our study demonstrated that LSND has similar efficiency to SND in terms of survival, recurrence, lymph node dissection, and perioperative recovery of patients with clinical stage IA solid-dominant NSCLC, as well as significant advantages in reducing postoperative complications. Therefore, curative lobectomies with LSND may be more suitable and practical for clinical stage IA solid-dominant patients with NSCLC. |
| Databáze: | OpenAIRE |
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