Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer

被引:7
作者
Kuroda, Hiroaki [1 ]
Ichinose, Junji [2 ]
Masago, Katsuhiro [3 ]
Takahashi, Yusuke [1 ]
Nakada, Takeo [1 ]
Nakao, Masayuki [2 ]
Okumura, Sakae [2 ]
Hashimoto, Kohei [2 ]
Matsuura, Yosuke [2 ]
Sakakura, Noriaki [1 ]
Matsushita, Hirokazu [4 ]
Mun, Mingyon [2 ]
机构
[1] Aichi Canc Ctr Hosp, Dept Thorac Surg, Nagoya, Aichi 4648681, Japan
[2] Canc Inst Hosp, Dept Thorac Surg Oncol, Tokyo 1358550, Japan
[3] Aichi Canc Ctr, Dept Pathol & Mol Diagnost, Nagoya, Aichi 4640021, Japan
[4] Aichi Canc Ctr, Div Translat Oncoimmunol, Res Inst, Nagoya, Aichi 4640021, Japan
来源
MEDICINA-LITHUANIA | 2021年 / 57卷 / 12期
关键词
non-small cell lung cancer; lobe-specific lymph node dissection; systemic lymph node dissection; carcinoembryonic antigen; lobectomy; LONG-TERM SURVIVAL; CLASSIFICATION; SURGERY;
D O I
10.3390/medicina57121365
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Objectives: Lobe-specific nodal dissection (L-SND) is currently acceptable for the dissection of early-stage non-small cell lung cancer (NSCLC) but not for cancers of more advanced clinical stages. We aimed to assess the efficacy of L-SND, compared to systemic nodal dissection (SND). Materials and Methods: We retrospectively collected the clinical data of patients with carcinoembryonic antigen (CEA) abnormality who underwent complete resection of NSCLC via lobectomy or more in addition to either SND or L-SND at two cancer-specific institutions from January 2006 to December 2017. Results: A total of 799 patients, including 265 patients who underwent SND and 534 patients who underwent L-SND, were included. On multivariate analysis, thoracotomy, more than lobectomy, cN1-2, advanced pathological stage, adjuvant treatment, and EGFR or ALK were strongly associated with SND. No significant differences were found in overall survival, disease-free survival, and overtime survival after propensity adjustment (p = 0.09, p = 0.11, and p = 0.50, respectively). There were no significant differences in local (p = 0.16), regional (p = 0.72), or distant (p = 0.39) tumor recurrence between the two groups. Conclusions: SND did not improve the prognosis of NSCLC patients with CEA abnormality. Complete pulmonary resection via L-SND seems useful for NSCLC patients with CEA abnormality.
引用
收藏
页数:11
相关论文
共 26 条
[1]   Subcarinal lymph node in upper lobe non-small cell lung cancer patients: Is selective lymph node dissection valid? [J].
Aokage, Keiju ;
Yoshida, Junji ;
Ishii, Genichiro ;
Hishida, Tomoyuki ;
Nishimura, Mitsuyo ;
Nagai, Kanji .
LUNG CANCER, 2010, 70 (02) :163-167
[2]   Adjuvant and Neoadjuvant Immunotherapy in Non - small Cell Lung Cancer [J].
Broderick, Stephen R. .
THORACIC SURGERY CLINICS, 2020, 30 (02) :215-+
[3]   European trends in preoperative and intraoperative nodal staging: ESTS guidelines [J].
De Leyn, P. ;
Lardinois, D. ;
Van Schil, P. ;
Rami-Porta, R. ;
Passlick, B. ;
Zielinski, M. ;
Waller, D. ;
Lerut, T. ;
Weder, W. .
JOURNAL OF THORACIC ONCOLOGY, 2007, 2 (04) :357-361
[4]   Non-Small Cell Lung Cancer, Version 1.2020 Featured Updates to the NCCN Guidelines [J].
Ettinger, David S. ;
Wood, Douglas E. ;
Aggarwal, Charu ;
Aisner, Dara L. ;
Akerley, Wallace ;
Bauman, Jessica R. ;
Bharat, Ankit ;
Bruno, Debora S. ;
Chang, Joe Y. ;
Chirieac, Lucian R. ;
D'Amico, Thomas A. ;
Dilling, Thomas J. ;
Dobelbower, Michael ;
Gettinger, Scott ;
Govindan, Ramaswamy ;
Gubens, Matthew A. ;
Hennon, Mark ;
Horn, Leora ;
Lackner, Rudy P. ;
Lanuti, Michael ;
Leal, Ticiana A. ;
Lin, Jules ;
Loo, Billy W., Jr. ;
Martins, Renato G. ;
Otterson, Gregory A. ;
Patel, Sandip P. ;
Reckamp, Karen L. ;
Riely, Gregory J. ;
Schild, Steven E. ;
Shapiro, Theresa A. ;
Stevenson, James ;
Swanson, Scott J. ;
Tauer, Kurt W. ;
Yang, Stephen C. ;
Gregory, Kristina ;
Hughes, Miranda .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2019, 17 (12) :1464-1472
[5]   Is lobe specific lymph node dissection adequate for cN0-1 non-small cell lung cancer? [J].
Fang, Likui ;
Xu, Jinming ;
Ye, Bo ;
Yu, Guocan ;
Chen, Gang ;
Yang, Jun .
JOURNAL OF CARDIOTHORACIC SURGERY, 2020, 15 (01)
[6]   Validation of the lung cancer staging system revisions using a large prospective clinical trial database (ACOSOG Z0030) [J].
Fibla, Juan J. ;
Cassivi, Stephen D. ;
Decker, Paul A. ;
Allen, Mark S. ;
Darling, Gail E. ;
Landreneau, Rodney J. ;
McKenna, Robert J. ;
Putnam, Joe B. .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2013, 43 (05) :911-914
[7]   The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer [J].
Goldstraw, Peter ;
Chansky, Kari ;
Crowley, John ;
Rami-Porta, Ramon ;
Asamura, Hisao ;
Eberhardt, Wilfried E. E. ;
Nicholson, Andrew G. ;
Groome, Patti ;
Mitchell, Alan ;
Bolejack, Vanessa .
JOURNAL OF THORACIC ONCOLOGY, 2016, 11 (01) :39-51
[8]   The clinicopathological features associated with skip N2 metastases in patients with clinical stage IA non-small-cell lung cancer [J].
Gorai, Atsuo ;
Sakao, Yukinori ;
Kuroda, Hiroaki ;
Uehara, Hirofumi ;
Mun, Mingyon ;
Ishikawa, Yuichi ;
Nakagawa, Ken ;
Masuda, Munetaka ;
Okumura, Sakae .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2015, 47 (04) :653-658
[9]   Prognostic Impact of the Current Japanese Nodal Classification on Outcomes in Resected Non-small Cell Lung Cancer [J].
Ichinose, Junji ;
Murakawa, Tomohiro ;
Hino, Haruaki ;
Konoeda, Chihiro ;
Inoue, Yuta ;
Kitano, Kentaro ;
Nagayama, Kazuhiro ;
Nitadori, Jun-ichi ;
Anraku, Masaki ;
Nakajima, Jun .
CHEST, 2014, 146 (03) :644-649
[10]   Are Lobe-Specific Mediastinal Lymph Node Dissections Reasonable for Peripheral Stage Ia Non-small Cell Lung Cancer? [J].
Karush, Justin M. .
ANNALS OF SURGICAL ONCOLOGY, 2020, 27 (02) :331-332