Hughes Michael J, Chowdhry Mohammed F, Woolley Steve M, Walker William S
Department of Thoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
Interact Cardiovasc Thorac Surg. 2011 Sep;13(3):311-5. doi: 10.1510/icvts.2011.268979. Epub 2011 May 22.
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients undergoing lung resection for non-small cell lung cancer, is lymph node dissection or sampling superior?' Altogether 845 papers were found using the reported search, of which 14 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that in stage I tumours there is little difference in survival when performing either mediastinal lymph node dissection (MLND) or lymph node sampling. However, survival is increased when performing MLND in stage II to IIIa tumours. Increased accuracy in staging is not observed with MLND. However, MLND reliably identifies more positive N2 nodes which may offer advantages in postoperative adjuvant treatment in more advanced disease.
根据结构化方案撰写了一篇胸外科最佳证据主题文章。所探讨的问题是“在接受非小细胞肺癌肺切除术的患者中，淋巴结清扫或采样哪种更具优势？”通过报告的检索共找到845篇论文，其中14篇代表了回答该临床问题的最佳证据。现将这些论文的作者、期刊、出版日期和国家、所研究的患者组、研究类型、相关结局及结果制成表格。我们得出结论，对于I期肿瘤，进行纵隔淋巴结清扫（MLND）或淋巴结采样时生存率差异不大。然而，对于II至IIIa期肿瘤，进行MLND可提高生存率。MLND并未观察到分期准确性的提高。然而，MLND能可靠地识别出更多阳性N2淋巴结，这可能对更晚期疾病的术后辅助治疗具有优势。
