Does an extended mediastinal lymphadenectomy improve outcome after R0 resection in lung cancer?

查看全文 作　　者：Nan [1]Wu;Shi [1]Yan;Chao [1]Lv;Shaolei [1]Li;Yuan [1]Feng;Yuzhao [1]Wang;Jia [1]Wang;Qingfeng [1]Zheng;Yue [1]Yang

机构地区：[1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute

出　　处：《Chinese Journal of Cancer Research》索引2014年第26卷第2期,共9页

基　　金：supported partially by the Strategic Priority Research Program of the Chinese Academy of Sciences (XDA06020101);the National Natural Science Foundation (No. 81350028);the National High Technology Research and Development Program of China (863 Program, No. 2012AA02A502);the Beijing Municipal Science & Technology Commission (No. Z111107067311018) 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 R0 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. 关键词：淋巴结肺癌预后反渗透质量改进多因素分析对照组 DFS

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Does an extended mediastinal lymphadenectomy improve outcome after R0 resection in lung cancer?

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