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摘要
Objective: This retrospective study was conducted to investigate the impact of more extended mediastinal lymphadenectomy on the outcome of lung cancer patients treated with RU resection.
Methods: During the investigation period, 325 lung cancer cases were enlisted and 278 cases entered the analysis. The patients were divided into Control group (n=116) and Research group (n=162) according to the different extents of mediastinal lymph node clearance at different time periods. Three major parameters were retrospectively assessed to compare the quality of surgical care: extent of lymph node clearance, resection volume, and postoperative recovery process and common complications. Comparison of the outcome between two groups was carried out.
Results: Research group showed a significant quality improvement of lymphadenectomy, such as more mediastinal node stations investigated (more than 3 N2 stations investigated: Research group, 90.7% vs. Control group, 55.2%; P=0.001) and more nodes collection (total nodes 26.1 +/- 10.0 vs. 19.1 +/- 8.3, P=0.000; N2 nodes 15.5 +/- 7.2 vs. 9.8 +/- 5.6, P=0.000). However, overall survival (OS) and disease-free survival (DFS) were not significantly different either between two groups (5-year OS: Control group, 56.4 +/- 4.6% vs. Research group, 62.6 +/- 4.3%; P=0.271) or between subgroups from stage I to IIIa. TNM stage and histology were significant factors associated with OS and DFS in multivariate analysis; extent of mediastinal lymphadenectomy was not associated with OS or DFS.
Conclusions: More radical mediastinal lymphadenectomy may not lead to an improved oncological outcome for lung cancer treated with R0 resection.
- 出版日期2014-4
- 单位北京市肿瘤防治研究所
