Impact of different mediastinal lymphadenectomy on clinical-stage IA non-small cell lung cancer
OBJECTIVE: To study the role of different lymphadenectomy in the treatment of selected clinical-stage IA non-small cell lung cancer.
METHODS: All 115 postoperative patients admitted from January 1997 to May 2002 with pathologic-stage T1 who had been preoperatively diagnosed as clinical-stage I A non-small cell lung cancer were divided into a radical systematic mediastinal lymphadenectomy (LA) group and a mediastinal lymph node sampling (LS) group. Impacts on morbidity, N staging, overall survival (OS) and disease-free survival (DFS) were evaluated in each group respectively. Associations between clinical-pathological parameters (age, sex, tumor location, tumor size, pathological type and lymph node metastases) and OS, DFS were analyzed. The cumulative OS and DFS was calculated by the Kaplan-Meier method and compared by the Log-rank test.
RESULTS: The mean number of dissected lymph nodes was (15.98 +/- 3.05) in LA group and (6.48 +/- 2.16) in LS group with a significant difference (P < 0.01). No statistically significant difference existed in modification of N staging, OS and DFS between LA group and LS group. However, for patients with lesions of a diameter more than 2 cm, 5-year OS in LA group was significantly higher than that in LS groups (LA vs. LS = 78.2% vs. 54.5% ,P < 0.05), also 5-year DFS was significantly higher (LA vs. LS = 75.1% vs. 51.3%, P < 0.05). For patients with lesions of 2 cm or less, 5-year OS and 5-year DFS were similar in both groups. The early surgery-related parameters (duration of surgery, drain secretion and morbidity) indicated a slighter invasion in LS group. In addition, patients with large cell carcinoma and adenosquamous carcinoma were associated with significantly poor 5-year OS (P < 0.05) , and patients with lymph node metastases were associated with poor 5-year OS as well as 5-year DFS (P < 0.01).
CONCLUSIONS: After being intraoperatively identified as T1 stage, patients with lesions of more than 2 cm in clinical-stage IA non-small cell lung cancer should be performed with LA to get a better survival, and patients with lesions of 2 cm or less should be performed with LS to decrease invasion.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2008 |
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| Erschienen: |
2008 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:46 |
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| Enthalten in: |
Zhonghua wai ke za zhi [Chinese journal of surgery - 46(2008), 9 vom: 01. Mai, Seite 670-3 |
| Sprache: |
Chinesisch |
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| Beteiligte Personen: |
Ma, Kai [VerfasserIn] |
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| Themen: |
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| Anmerkungen: |
Date Completed 21.04.2009 Date Revised 29.10.2008 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM18401770X |
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| 245 | 1 | 0 | |a Impact of different mediastinal lymphadenectomy on clinical-stage IA non-small cell lung cancer |
| 264 | 1 | |c 2008 | |
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| 500 | |a Date Completed 21.04.2009 | ||
| 500 | |a Date Revised 29.10.2008 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To study the role of different lymphadenectomy in the treatment of selected clinical-stage IA non-small cell lung cancer | ||
| 520 | |a METHODS: All 115 postoperative patients admitted from January 1997 to May 2002 with pathologic-stage T1 who had been preoperatively diagnosed as clinical-stage I A non-small cell lung cancer were divided into a radical systematic mediastinal lymphadenectomy (LA) group and a mediastinal lymph node sampling (LS) group. Impacts on morbidity, N staging, overall survival (OS) and disease-free survival (DFS) were evaluated in each group respectively. Associations between clinical-pathological parameters (age, sex, tumor location, tumor size, pathological type and lymph node metastases) and OS, DFS were analyzed. The cumulative OS and DFS was calculated by the Kaplan-Meier method and compared by the Log-rank test | ||
| 520 | |a RESULTS: The mean number of dissected lymph nodes was (15.98 +/- 3.05) in LA group and (6.48 +/- 2.16) in LS group with a significant difference (P < 0.01). No statistically significant difference existed in modification of N staging, OS and DFS between LA group and LS group. However, for patients with lesions of a diameter more than 2 cm, 5-year OS in LA group was significantly higher than that in LS groups (LA vs. LS = 78.2% vs. 54.5% ,P < 0.05), also 5-year DFS was significantly higher (LA vs. LS = 75.1% vs. 51.3%, P < 0.05). For patients with lesions of 2 cm or less, 5-year OS and 5-year DFS were similar in both groups. The early surgery-related parameters (duration of surgery, drain secretion and morbidity) indicated a slighter invasion in LS group. In addition, patients with large cell carcinoma and adenosquamous carcinoma were associated with significantly poor 5-year OS (P < 0.05) , and patients with lymph node metastases were associated with poor 5-year OS as well as 5-year DFS (P < 0.01) | ||
| 520 | |a CONCLUSIONS: After being intraoperatively identified as T1 stage, patients with lesions of more than 2 cm in clinical-stage IA non-small cell lung cancer should be performed with LA to get a better survival, and patients with lesions of 2 cm or less should be performed with LS to decrease invasion | ||
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Wang, Tian-You |e verfasserin |4 aut | |
| 700 | 1 | |a He, Bao-Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Gong, Min |e verfasserin |4 aut | |
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