Efficacy of systematic versus lobe-specific lymph node dissection in the treatment of clinicalⅠA stage lung adenocarcinoma: A propensity score matching study in a single center
- VernacularTitle:系统性与叶特异性淋巴结清扫治疗cⅠA期肺腺癌疗效比较的单中心倾向性评分匹配分
- Author:
Tengfei YI
1
;
Kun QIN
2
;
Shengteng SHAO
1
;
Shuo LI
1
;
Yuhong LIU
1
Author Information
1. Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266071, Shandong, P. R. China
2. Department of Emergency Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266071, Shangdong, P. R. China
- Publication Type:Journal Article
- Keywords:
Clinical ⅠA stage lung adenocarcinoma;
systematic lymph node dissection;
lobe-specific lymph node dissection;
prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(08):1143-1150
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effects of systematic lymph node dissection (SLND) and lobe-specific lymph node dissection (L-SND) on perioperative and long-term outcomes of patients with clinicalⅠA (cⅠA) stage lung adenocarcinoma. Methods A retrospective analysis was done on the patients with cⅠA stage lung adenocarcinoma who received thoracoscopic radical resection admitted to the Affiliated Hospital of Qingdao University from January 2013 to August 2016. Propensity score matching was conducted to eliminate the biases. The recurrence-free survival was compared between the two groups after matching. Perioperative parameters and postoperative complications were also analyzed. Results A total of 725 patients were enrolled, including 252 males and 473 females, with a median age of 62.0 (31.0-69.0) years. There were 228 patients in the L-SND group and 497 patients in the SLND group. After matching, there were 211 patients in each group and no statistical difference in the incidence of postoperative complications (10.9% vs. 13.7%, P=0.374), identification of metastatic positive lymph nodes (12.3% vs. 9.0%, P=0.270), or recurrence-free survival (P=0.492) were found between two groups, whereas the operation time (163.9±39.4 min vs. 135.4±32.4 min, P<0.001), intraoperative blood loss [100.0 (20.0-800.0) mL vs. 100.0 (10.0-400.0) mL, P<0.001], intubation time [4.0 (1.0-18.0) d vs. 4.0 (1.0-9.0) d, P<0.001] and hospital stay (12.3±3.3 d vs. 10.8±2.4 d, P=0.003) in the SLND group were found to be significantly higher or longer than those in the L-SND group. Conclusion L-SND has a similar efficiency to SLND in terms of postoperative complications, pathological lymph node metastasis, and recurrence-free survival, as well as significant advantages in reducing intraoperative blood loss, and shortening operation time, intubation time and length of hospital stay. Therefore, L-SND can be recommended to replace SLND as a method for lymph node resection in patients with cⅠA stage lung adenocarcinoma.
