Abstract
Introduction
Surgery is the most effective treatment for early-stage lung cancer. This study will
propose a personalized plan for mediastinal lymph node dissection in early-stage lung
adenocarcinoma to reduce the risk of surgery and improve the quality of life.
Methods
This study retrospectively analyzed the patients underwent lobectomy and lymph node
dissection in the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University.
Clinical stage I lung adenocarcinoma patients with solid component ratio (CTR) between
0.5 and 1 were included. Patients were divided into systematic (S-MLND) and lobe-specific
(L-MLND) mediastinal lymph node dissection groups. The days of hospitalization, the
presence or absence of complications, the recurrence-free survival rate, and the overall
survival rate were calculated to evaluate the postoperative quality and operation
risk of the patients.
Results
210 patients (138 L-MLND and 72 S-MLND) were included. 2 lymph node metastases appeared
in the S-MLND group while none in the L-MLND group (P = .049). No differences were shown in age, tumor site, size, solid component, degree
of tumor invasion, and stage. The proportion of patients with severe postoperative
cough and the length of hospital stay in the L-MLND group decreased. The 5-year OS
of the entire cohort was 98.1%, 98.6% in L-MLND, compared with 97.2% in S-MLND; RFS
was 94.8%, 95.7% in L-MLND, compared with 93.0% in S-MLND.
Conclusion
For cIA lung adenocarcinoma, according to the Thin-slice CT within 1 month before
the operation, if the main lesion was less than 3 cm and CTR over 0.5, L-MLND is as
effective as S-MLND.
Keywords
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Article info
Publication history
Published online: August 14, 2022
Accepted:
August 8,
2022
Received in revised form:
July 12,
2022
Received:
April 7,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
