PMID- 37622593
OWN - NLM
STAT- MEDLINE
DCOM- 20231211
LR  - 20231211
IS  - 1465-3621 (Electronic)
IS  - 0368-2811 (Linking)
VI  - 53
IP  - 12
DP  - 2023 Dec 7
TI  - A multicenter propensity score-matched analysis of lymphadenectomy in N1-positve 
      lung cancer.
PG  - 1183-1190
LID - 10.1093/jjco/hyad110 [doi]
AB  - OBJECTIVES: Selective mediastinal lymph node dissection based on lobe-specific 
      metastases is widely recognized in daily practice. However, the significance of 
      mediastinal lymph node dissection for N1-positive tumors has not been elucidated. 
      METHODS: We retrospectively reviewed 359 patients with N1-positive lung cancer 
      who underwent lobectomy with systematic mediastinal lymph node dissection 
      (systematic lymph node dissection) (n = 150) and lobe-specific mediastinal lymph 
      node dissection (lobe-specific lymph node dissection) (n = 209). The operative 
      and postoperative results and their propensity score-matched pairs were compared. 
      The factors affecting survival were assessed using competing risk and 
      multivariable analyses. RESULTS: The cumulative incidence of recurrence and the 
      cumulative incidence of cancer-specific death were not significantly different 
      between systematic and lobe-specific lymph node dissection in entire cohort. In 
      the propensity score-matched cohort (83 pairs), systematic lymph node dissection 
      tended to detect N2 lymph node metastasis more frequently (55.4 vs. 41%, 
      P = 0.087). Eleven patients (13.2%) in the systematic lymph node dissection group 
      had a metastatic N2 lymph node 'in the systematic lymph node dissection field' 
      that lobe-specific lymph node dissection did not dissect. The oncological 
      outcomes between patients undergoing systematic lymph node dissection (5-year 
      cumulative incidence of recurrence, 62.1%; 5-year cumulative incidence of 
      cancer-specific death, 27.9%) and lobe-specific lymph node dissection (5-year 
      cumulative incidence of recurrence, 60.1%; 5-year cumulative incidence of 
      cancer-specific death, 23.3%) were similar. The propensity score-adjusted 
      multivariable analysis for cumulative incidence of recurrence revealed that the 
      prognosis associated with systematic lymph node dissection was comparable with 
      the prognosis with lobe-specific lymph node dissection (hazard ratio, 1.17; 95% 
      confidence interval, 0.82-1.67; P = 0.37). CONCLUSIONS: The extent of lymph node 
      dissection can affect accurate pathological staging; however, it was not 
      associated with survival outcome in the treatment of N1-positive lung cancer.
CI  - (c) The Author(s) 2023. Published by Oxford University Press. All rights reserved. 
      For permissions, please e-mail: journals.permissions@oup.com.
FAU - Handa, Yoshinori
AU  - Handa Y
AUID- ORCID: 0009-0004-4890-2019
AD  - Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
FAU - Tsutani, Yasuhiro
AU  - Tsutani Y
AUID- ORCID: 0000-0001-8836-1027
AD  - Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
FAU - Mimae, Takahiro
AU  - Mimae T
AUID- ORCID: 0000-0001-9993-8928
AD  - Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
FAU - Miyata, Yoshihiro
AU  - Miyata Y
AD  - Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
FAU - Ito, Hiroyuki
AU  - Ito H
AD  - Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
FAU - Shimada, Yoshihisa
AU  - Shimada Y
AD  - Department of Surgery, Tokyo Medical University, Tokyo, Japan.
FAU - Nakayama, Haruhiko
AU  - Nakayama H
AD  - Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
FAU - Ikeda, Norihiko
AU  - Ikeda N
AD  - Department of Surgery, Tokyo Medical University, Tokyo, Japan.
FAU - Okada, Morihito
AU  - Okada M
AUID- ORCID: 0000-0002-0601-3828
AD  - Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Jpn J Clin Oncol
JT  - Japanese journal of clinical oncology
JID - 0313225
SB  - IM
MH  - Humans
MH  - *Lung Neoplasms/pathology
MH  - *Carcinoma, Non-Small-Cell Lung/pathology
MH  - Retrospective Studies
MH  - Propensity Score
MH  - Pneumonectomy/methods
MH  - Lymph Node Excision/methods
MH  - Lymph Nodes/surgery/pathology
MH  - Neoplasm Staging
OTO - NOTNLM
OT  - lobectomy
OT  - lymphadenectomy
OT  - non-small cell lung cancer
OT  - prognosis
OT  - propensity score-matched analysis
EDAT- 2023/08/25 12:42
MHDA- 2023/12/11 12:42
CRDT- 2023/08/25 07:32
PHST- 2023/05/18 00:00 [received]
PHST- 2023/08/08 00:00 [accepted]
PHST- 2023/12/11 12:42 [medline]
PHST- 2023/08/25 12:42 [pubmed]
PHST- 2023/08/25 07:32 [entrez]
AID - 7250139 [pii]
AID - 10.1093/jjco/hyad110 [doi]
PST - ppublish
SO  - Jpn J Clin Oncol. 2023 Dec 7;53(12):1183-1190. doi: 10.1093/jjco/hyad110.