Significance of Lymphadenectomy in Part-Solid Lung Adenocarcinoma: Propensity Score Matched Analysis

The Annals of Thoracic Surgery
Aritoshi HattoriKenji Suzuki

Abstract

It is evident that the frequency of nodal metastasis in part-solid lung adenocarcinoma is significantly low. For those cases, the prognostic impact of the lymph node dissection (LND) is highly controversial. We reviewed 462 clinical stage I radiologic part-solid lung adenocarcinoma patients who underwent lobectomy or segmentectomy with lymphadenectomy. Consolidation tumor ratio was evaluated for all patients. Extent of LND was classified into systematic/lobe-specific mediastinal LND (m-LND) and hilar LND only (h-LND). Prognostic significance of LND was assessed by a multivariable analysis using propensity score matching. Survival was calculated by the Kaplan-Meier method using the log rank test. The m-LND was performed in 314 patients (68%), and h-LND in 148 (32%). Overall survival (OS) was not significantly different between m-LND and h-LND (5-year OS, 94.2% versus 92.8%, p = 0.585), as shown in 92 matched pairs (5-year OS, 94.0% versus 93.2%, p = 0.845). Cox proportional hazards model revealed maximum standardized uptake value as an independently significant oncologic prognosticator (p = 0.003), but extent of LND was not (p = 0.997). Nodal involvement was found in 16 patients, and was exclusive in solid-dominant lesions (ie, ...Continue Reading

Citations

Nov 30, 2019·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Raymond U OsarogiagbonMatthew P Smeltzer
Oct 9, 2019·The Annals of Thoracic Surgery·Aritoshi HattoriKenji Suzuki
Mar 23, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Aritoshi HattoriKenji Suzuki
Jan 19, 2022·Asian Cardiovascular & Thoracic Annals·Keiji YamanashiHiroshi Date

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