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ORIGINAL ARTICLE
Year : 2013  |  Volume : 9  |  Issue : 5  |  Page : 101-105

Comparison of lobe-specific mediastinal lymphadenectomy versus systematic mediastinal lymphadenectomy for clinical stage T 1a N 0 M 0 non-small cell lung cancer


1 Department of General Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Province, 250021, China
2 Department of General Thoracic Surgery, The People's Hospital of Weifang municipalities, Shandong Province, 250021, China

Correspondence Address:
Lin Zhang
Department of General Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.119119

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Objective: This study was to explore the appropriate extent of mediastinal lymph node dissection for clinical stage T 1a N 0 M 0 non-small cell lung cancer (NSCLC) by comparison between two modes of mediastinal lymph node dissection. Materials and Methods: A total of 96 clinical stage T 1a N 0 M 0 NSCLC cases received radical surgery were randomly divided to lobe-specific mediastinal lymphadenectomy (LL) group and systematic mediastinal lymphadenectomy (SL) group from the year 2004 to 2008. The effects of SL and LL on morbidity, N staging, overall survival (OS) and disease-free survival (DFS) were investigated. Meanwhile, associations between clinicopathological parameters and metastasis of lymph nodes were analyzed. Results: The mean operating time and blood loss in LL group were significantly less than that in the SL group (135.48 ± 25.44 min vs. 180.85 ± 39.36 min, 155.11 ± 25.17 ml vs. 161.32 ± 28.20 ml, P < 0.05), the mean numbers of dissected lymph nodes of the SL group was significantly greater than that in the LL group (17.1 ± 3.7 vs. 9.4 ± 2.1, P < 0.05). The post-operative overall morbidity rate was higher in the SL group than that in the LL group (P < 0.05). There were no significant difference in migration of N staging, OS and DFS between two groups. The post-operative N staging, the tumor cells differentiation and the ratio of ground glass opacity (GGO) in tumor were the independent factors influencing long-term survival. Moreover, the significant correlation was seen between the metastasis of lymph nodes and clinicopathological parameters including tumor location and the GGO ratio. Conclusion: The LL group had similar efficacy as the SL group in the clinical stage T 1a N 0 M 0 NSCLC and there was unnecessary to perform systematic lymphadenectomy in such patients with a high ratio of GGO.


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