Abstract
Background Lobectomy and mediastinal lymph node dissection comprise the standard surgical treatment
for non-small cell lung cancer (NSCLC). Although complete mediastinal lymph node dissection
has been recommended as part of the procedure for achieving complete resection, the
benefits for early lung cancer are unclear. The purpose of this study was to determine
the effects of different degrees of mediastinal lymph node dissection on the clinical
outcomes of patients with clinical stage I NSCLC.
Materials and Methods The records of patients with clinical stage I NSCLC treated between January 2000
and September 2010 were reviewed retrospectively. This study consisted of 211 patients
who underwent lobectomy plus mediastinal lymph node dissection and sampling. Patients
were divided into a group who underwent lymphadenectomy (LA) including complete mediastinal
node dissection or lobe-specific lymph node dissection and a group who underwent selective
lymph node sampling (LS). Clinical outcomes, including survival, and prognostic factors
were determined.
Results The mean (±) number of extracted lymph nodes for the LS and LA patients was 7.50 ± 5.44
and 14.09 ± 7.57, respectively (p < 0.001). Male and diabetes mellitus patients were more associated with LS. Survival
of the LA patients was significantly longer (p = 0.029). By multivariate analysis, extent of mediastinal nodal sampling (p = 0.029) and positive for mediastinal nodal (N2-positive) disease (p = 0.046) were significant predictors for survival.
Conclusions The extent of dissection of mediastinal lymph nodes affected the clinical outcomes
of our study patients with clinical stage I NSCLC. At least evaluation of lobe-specific
lymph node dissection is required.
Keywords
chest - lung cancer treatment - outcomes
