Selective Mediastinal Lymphadenectomy for Clinico-Surgical Stage I Non–Small Cell Lung Cancer

Okada, Morihito; Sakurai, Toshihiko; Yuki, Tsuyoshi; Mimura, Takashi; Miyoshi, Kazunori; Tsubota, Noriaki

doi:10.1016/j.athoracsur.2005.09.078

Cited by 129 publications

(126 citation statements)

References 10 publications

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“…4) For clinically early stage lung cancers, radical lymph node dissection may then be reasonably omitted, since metastasis beyond these lobe-specific nodes has been especially uncommon. 5,6) Several subsequent clinical trials have also verified that selective nodal dissection simply on these lobe-specific nodes offered similar survival compared to systematic lymphadenectomy. 7,8) However, for stage-III (TxN2M0) lung cancers, the definition of the term "lobe-specific node" may have additional prognostic significance.…”

Section: Mediastinal Lymph-nodes Metastasis Beyond the Lobe-specific:mentioning

confidence: 99%

Mediastinal Lymph-nodes Metastasis beyond the Lobe-specific: An Independent Risk Factor toward Worse Prognoses

Sun¹,

Gao²,

Zheng³

et al. 2014

ATCS

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Purpose: Five-year survival rates were widely dispersed in pN2 non-small cell lung cancer (NSCLC). The present study aims to investigate the prognosis of patients with lymph node metastasis beyond lobe-specific mediastinal regions. Methods: A total of 654 pathologically proved N2-NSCLC patients were enrolled. All patients underwent a major pulmonary resection and radical mediastinal lymphadenectomy. Two separate groups were assigned according to the definition of lobe-specific nodal metastasis: Group LS (lobe-specific) and Group NLS (non-lobe-specific). Survival rates were calculated using Kaplan-Meier and Cox regression models. Results: There were 376 cases in Group LS and 278 cases in Group NLS. Univariate analyses showed that the risk factors of 5-year survival were operation type, MLN positivity ratio, nodal station, nodal zone, and LS/NLS metastasis. The 5-year survival among those in Group LS was significantly better than that of Group NLS (27.5% vs. 11.7%, p <0.0001). Multivariate analysis confirmed that the grouping method of LS/NLS and number of involved nodal zones were the most prominent risk factors for 5-year survival. Conclusion: Lymph node metastasis beyond lobe-specific lymph nodes is an independent risk factor of 5-year survival and is associated with worse prognoses for N2 NSCLC patients.

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Section: Mediastinal Lymph-nodes Metastasis Beyond the Lobe-specific:mentioning

confidence: 99%

Mediastinal Lymph-nodes Metastasis beyond the Lobe-specific: An Independent Risk Factor toward Worse Prognoses

Sun¹,

Gao²,

Zheng³

et al. 2014

ATCS

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“…Meanwhile, Izbicki (10) and Graham (38) argued that LND should be routinely operated for resectable NSCLC. On one hand, whether LND would increase postoperative morbidity associated with complications is not clear (10,36) and the influence on outcome such as overall survival and diseasefree survival remains controversial (5,8,17,33,34). On the other hand, the reported benefit that SLND can shorten the entire medical period along with its validity, reliability and applicability are still not very clear.…”

Section: Discussionmentioning

confidence: 94%

“…Some retrospective studies have demonstrated SLND is an alternative to LND for selected clinical-stage I-II patients and has the potential to become a standard procedure in surgical treatment for NSCLC (11,33,34,36,37). Meanwhile, Izbicki (10) and Graham (38) argued that LND should be routinely operated for resectable NSCLC.…”

Section: Discussionmentioning

confidence: 99%

Selective lymph node dissection in early-stage non-small cell lung cancer

Han

Chen

2017

J. Thorac. Dis.

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Lymph node dissection is a vital part of surgical treatment in early-stage non-small cell lung cancer (NSCLC). Removal of metastatic lymph nodes while preservation of intact lymph nodes are equally important. For hospitalized early-stage patients with limited lymph node metastasis, the operation treatment should be made according to some rules such as lobe-specific lymph node drainage pattern. In order to prevent unnecessary surgical trauma in early-stage patients, a minimally invasive approach with selective lymph node excision is preferred for more clinical benefits. This review summarizes the existing findings on lobe-specific lymph node drainage pattern and we hope to provide guidance for selective lymph node dissection (SLND). Furthermore, we include information on histologic views, a tumor marker and protocols of SLND, with hope to inspire creative research and clinical trials in this field.

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“…Okada et al (15) performed SND in 377 patients between 1985 and 1996 and LSD in 358 patients between 1997 and 2002, and they reported that LSD for stage I NSCLC was as effective as SND. They also reported that the morbidity of the patients undergoing LSD was less than that for those undergoing SND.…”

Section: Editorialmentioning

confidence: 99%

“…Asamura (14) reported that tumors of the right lower lobe with superior mediastinal metastasis were associated with a poorer 5-year survival rate of 4.1%. Based on the results of the lobe-specific patterns of nodal metastases, lobe-specific nodal dissection (LSD) has been developed (15)(16)(17)(18).…”

mentioning

confidence: 99%

Has lobe-specific nodal dissection for early-stage non-small lung cancer already become standard treatment?

Maniwa

Kodama

2016

J. Thorac. Dis.

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Selective Mediastinal Lymphadenectomy for Clinico-Surgical Stage I Non–Small Cell Lung Cancer

Cited by 129 publications

References 10 publications

Mediastinal Lymph-nodes Metastasis beyond the Lobe-specific: An Independent Risk Factor toward Worse Prognoses

Mediastinal Lymph-nodes Metastasis beyond the Lobe-specific: An Independent Risk Factor toward Worse Prognoses

Selective lymph node dissection in early-stage non-small cell lung cancer

Has lobe-specific nodal dissection for early-stage non-small lung cancer already become standard treatment?

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