Research for Mediastinal Lymph Node Desection Style of Stage Ib Upper Lobe Non-small Cell Lung Cancer
10.3779/j.issn.1009-3419.2013.11.04
- VernacularTitle:Ib期上叶肺癌纵隔淋巴结清扫方式的研究
- Author:
WANG WENLI
1
;
MAO FENG
;
SHEN-TU YANG
;
MEI YUNQING
Author Information
1. 同济大学附属同济医院心胸外科
- Keywords:
Lung neoplasms;
Stage Ib;
Lymphadenectomy;
Prognosis
- From:
Chinese Journal of Lung Cancer
2013;(11):584-590
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Lymphatic metastasis is the most important way for the spread of lung cancer and is one of the important factors affecting the prognosis. Existing studies showed that compared to middle or lower lobe NSCLC, upper lobe non-small cell lung cancer (NSCLC) has a higher probability of occurring regional mediastinal lymph node metastasis. hTe purpose of this study is to research the prognostic factors and lymphadenectomy of stage Ib upper lobe NSCLC. Methods A retrospective study of 147 consecutive subjects (76 and 71 for right and letf upper lobe NSCLC respec-tively) who had undergone curative resection for stage Ib upper lobe NSCLC was performed. A total of 925 lymph nodes were removed during the surgery in all enrolled patients and a total of 491 mediastinal lymph nodes (266 and 225 for superior and inferior mediastinal lymph nodes respectively) were removed. Kaplan-Meier product method and Log-rank test were used for univariate survival analysis and Cox regression model was used for multivariate survival analysis. Results ①Both univariate and multivariate analysis showed that age, tumor size and number of removed superior mediastinal lymph node stations were the important prognostic factors of stage Ib upper lobe NSCLC;②For stage Ib right upper lobe NSCLC, station 4 lymph node was of statistical signiifcance to the prognosis (P=0.021);while for stage Ib letf upper lobe NSCLC, station 5 lymph node was of statistical signiifcance to the prognosis (P=0.024). Conclusion In surgically treated stage Ib upper lobe NSCLC patients, age, tumor size and number of removed superior mediastinal lymph node stations are the important prognostic factors. And in this kind of patients, lobe-speciifc systematic lymph node dissection may be a more effcient procedure during the surgery.
