Appropriate Extent of Lymphadenectomy in Segmentectomy: A Multicenter Study. (18th November 2020)
- Record Type:
- Journal Article
- Title:
- Appropriate Extent of Lymphadenectomy in Segmentectomy: A Multicenter Study. (18th November 2020)
- Main Title:
- Appropriate Extent of Lymphadenectomy in Segmentectomy: A Multicenter Study
- Authors:
- Handa, Yoshinori
Tsutani, Yasuhiro
Mimae, Takahiro
Miyata, Yoshihiro
Ito, Hiroyuki
Nakayama, Haruhiko
Ikeda, Norihiko
Okada, Morihito - Abstract:
- Abstract: Background: The significance of lymphadenectomy is yet to be fully examined in segmentectomy. We compared the oncological outcomes of mediastinal lymph node dissection (LND) and hilar LND for lung cancer treated with segmentectomy via a multicenter database using propensity score-matched analysis. Methods: We reviewed 357 clinical stage IA radiologically solid-dominant lung cancer patients who underwent segmentectomy with lymphadenectomy. The extent of LND was classified into systematic/lobe-specific mediastinal LND and hilar LND only groups. Postoperative results after segmentectomy with mediastinal LND (n = 179) and hilar LND (n = 178) were analyzed for all patients and their propensity score-matched pairs. Results: Cancer-specific survival (CSS) and recurrence-free interval (RFI) rates for the mediastinal LND group were determined to be not significantly different compared with the hilar LND group in all non-adjusted cohorts. In the propensity score-matched cohort (129 pairs), mediastinal LND harvested more lymph nodes compared with hilar LND, and both groups had significantly different pathological stages ( P = 0.015). Adjuvant chemotherapy was performed in 10 (7.8%) patients in the mediastinal LND group and 4 (3.1%) in the hilar LND group. The mediastinal LND group tended to have better prognosis than the hilar LND group (5-year CSS rates, 97.4% vs 93.2%; 5-year RFI rates, 93.5% vs 88.5%). Conclusions: Mediastinal LND was found to provide more appropriateAbstract: Background: The significance of lymphadenectomy is yet to be fully examined in segmentectomy. We compared the oncological outcomes of mediastinal lymph node dissection (LND) and hilar LND for lung cancer treated with segmentectomy via a multicenter database using propensity score-matched analysis. Methods: We reviewed 357 clinical stage IA radiologically solid-dominant lung cancer patients who underwent segmentectomy with lymphadenectomy. The extent of LND was classified into systematic/lobe-specific mediastinal LND and hilar LND only groups. Postoperative results after segmentectomy with mediastinal LND (n = 179) and hilar LND (n = 178) were analyzed for all patients and their propensity score-matched pairs. Results: Cancer-specific survival (CSS) and recurrence-free interval (RFI) rates for the mediastinal LND group were determined to be not significantly different compared with the hilar LND group in all non-adjusted cohorts. In the propensity score-matched cohort (129 pairs), mediastinal LND harvested more lymph nodes compared with hilar LND, and both groups had significantly different pathological stages ( P = 0.015). Adjuvant chemotherapy was performed in 10 (7.8%) patients in the mediastinal LND group and 4 (3.1%) in the hilar LND group. The mediastinal LND group tended to have better prognosis than the hilar LND group (5-year CSS rates, 97.4% vs 93.2%; 5-year RFI rates, 93.5% vs 88.5%). Conclusions: Mediastinal LND was found to provide more appropriate pathological staging compared with hilar LND in patients with segmentectomy by harvesting more lymph nodes. In addition, mediastinal LND might lead to better oncological outcome than hilar LND in segmentectomy. Abstract : In segmentectomy, mediastinal LND could provide more appropriate pathological staging by harvesting more lymph nodes. In addition, mediastinal LND might lead to better oncological outcome than hilar LND. … (more)
- Is Part Of:
- Japanese journal of clinical oncology. Volume 51:Number 3(2021)
- Journal:
- Japanese journal of clinical oncology
- Issue:
- Volume 51:Number 3(2021)
- Issue Display:
- Volume 51, Issue 3 (2021)
- Year:
- 2021
- Volume:
- 51
- Issue:
- 3
- Issue Sort Value:
- 2021-0051-0003-0000
- Page Start:
- 451
- Page End:
- 458
- Publication Date:
- 2020-11-18
- Subjects:
- Segmentectomy -- Lymphadenectomy -- Prognosis -- Propensity score-matched analysis
Oncology -- Periodicals
Cancer -- Periodicals
616.994005 - Journal URLs:
- http://jjco.oupjournals.org/ ↗
http://ukcatalogue.oup.com/ ↗ - DOI:
- 10.1093/jjco/hyaa199 ↗
- Languages:
- English
- ISSNs:
- 0368-2811
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 4651.378000
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- 17087.xml