Wang Feng, Yu Xiangyang, Han Yi, Zhang Lanjun, Liu Shuku
Department of Minimally Invasive Surgery, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, P.R. China.
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China.
Mol Clin Oncol. 2023 May 16;18(6):50. doi: 10.3892/mco.2023.2646. eCollection 2023 Jun.
Lymph node dissection is used to treat early-stage lung cancer. The present study aimed to investigate if resecting the subcarinal lymph nodes affects prognosis of patients with stage IB non-small cell lung cancer (NSCLC). A total of 597 patients with stage IB NSCLC who underwent lung cancer surgery at Sun Yat-Sen University Cancer Center from January 1999 to December 2009 were included in the present study. The potential prognostic factors were evaluated using the Cox proportional hazard regression model. A total of 252 cases were obtained following propensity score matching (PSM). To compare overall survival (OS) and recurrence-free survival (RFS), Kaplan-Meier method and log-rank test were used. Among the 597 cases included, 185 did not undergo subcarinal lymph node resection, whereas 412 did. There were statistically significant differences between the two groups in terms of bronchial invasion, number of resected lymph node stations and resected lymph node numbers (P<0.05). Age, family history of cancer and the number of resected lymph nodes were prognostic factors for OS, whereas age and the number of resected lymph nodes were prognostic factors for RFS (P<0.05). Resection of subcarinal lymph nodes was not associated with OS and RFS. After PSM, survival analysis was recalculated using the Kaplan-Meier method and log-rank test; subcarinal lymph node resection was not statistically associated with OS and RFS. (P>0.05). For stage IB NSCLC, there was no statistically significant association between subcarinal lymph node resection and OS and RFS. Subcarinal lymph node resection in surgery of stage IB NSCLC may be considered optional.
淋巴结清扫术用于治疗早期肺癌。本研究旨在探讨切除隆突下淋巴结是否会影响ⅠB期非小细胞肺癌（NSCLC）患者的预后。本研究纳入了1999年1月至2009年12月在中山大学肿瘤防治中心接受肺癌手术的597例ⅠB期NSCLC患者。使用Cox比例风险回归模型评估潜在的预后因素。经过倾向评分匹配（PSM）后共获得252例病例。为比较总生存期（OS）和无复发生存期（RFS），采用Kaplan-Meier法和对数秩检验。在纳入的597例病例中，185例未进行隆突下淋巴结切除，而412例进行了切除。两组在支气管侵犯、切除的淋巴结站数和切除的淋巴结数量方面存在统计学显著差异（P<0.05）。年龄、癌症家族史和切除的淋巴结数量是OS的预后因素，而年龄和切除的淋巴结数量是RFS的预后因素（P<0.05）。隆突下淋巴结切除与OS和RFS无关。PSM后，使用Kaplan-Meier法和对数秩检验重新计算生存分析；隆突下淋巴结切除与OS和RFS无统计学关联（P>0.05）。对于ⅠB期NSCLC，隆突下淋巴结切除与OS和RFS之间无统计学显著关联。ⅠB期NSCLC手术中的隆突下淋巴结切除可视为可选择的。
