Association between number of dissected lymph nodes and survival in patients undergoing resection for clinical stage IA pure solid lung adenocarcinoma: a retrospective analysis

BMC Pulmonary Medicine

Research

Hui Du¹  Junfeng Liu²  Nan Zhang²  Yu Rong²  Xi’e Xu²  Jinhuan Yin²  Zhihua Shi²  Nianqiao Han²  Tao Jiang² 

[1] Department of Thoracic Surgery, The First Affiliated Hospital of Hebei North University, 075000, Zhangjiakou, Hebei, China;Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, 050011, Shijiazhuang, Hebei, China;

关键词: Lymph node dissection;    Recurrence-free survival;    Neoplasm staging;    Adenocarcinoma of the lung;   

DOI  :  10.1186/s12890-023-02675-2

 received in 2023-03-21, accepted in 2023-09-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLymph node dissection is essential for staging of pure solid lung adenocarcinoma and selection of treatment after surgical resection, particularly for stage I disease since the rate of lymph node metastasis can vary from 0 to 23.7%.MethodsWe retrospectively screened all adult patients (18 years of age or older) who underwent lobectomy for pure solid cT1N0M0 lung adenocarcinoma between January 2015 and December 2017 at our center. Cox proportional hazard regression was used to assess the association between the number of dissected lymph nodes and recurrence-free survival (RFS) and to determine the optimal number of dissected lymph nodes.ResultsThe final analysis included 458 patients (age: 60.26 ± 8.07 years; 241 women). RFS increased linearly with an increasing number of dissected lymph nodes at a range between 0 and 9. Kaplan-Meier analysis revealed significantly longer RFS in patients with ≥ 9 vs. <9 dissected lymph nodes. In subgroup analysis, ≥ 9 dissected lymph nodes was not only associated with longer RFS in patients without lymph node metastasis (n = 332) but also in patients with metastasis (n = 126). In multivariate Cox proportional hazard regression, ≥ 9 dissected lymph nodes was independently associated with longer RFS (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.26 to 0.73; P = 0.002).Conclusions≥9 Dissected lymph nodes was associated with longer RFS; accordingly, we recommend dissecting 9 lymph nodes in patients undergoing lobectomy for stage IA pure solid lung adenocarcinoma.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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