Selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer / 中华胸心血管外科杂志

ABSTRACT

Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.