Manfredini Beatrice, Zirafa Carmelina Cristina, Stefani Alessandro, Romano Gaetano, Alì Greta, Morganti Riccardo, Ceccarelli Ilaria, Davini Federico, Filosso Pier Luigi, Melfi Franca
Minimally Invasive and Robotic Thoracic Surgery, Surgical, Medical, Molecular and Critical Care Pathology Department, University of Pisa, 56126 Pisa, Italy.
Unit of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy.
Curr Oncol. 2025 Jan 5;32(1):31. doi: 10.3390/curroncol32010031.
Lymphadenectomy is considered a key part of the radical treatment of resectable lung cancer, although its appropriate extension in early stages is a debated topic due to the great heterogeneity of studies in the literature. This study aims to evaluate the impact of lymphadenectomy extent on survival and recurrence in the treatment of early-stage NSCLC patients undergoing lobectomy and lymph node dissection.
Data from clinical stage I NSCLC patients undergoing lobectomy and hilar-mediastinal lymphadenectomy at two thoracic surgery centers from 2016 to 2019 were retrospectively evaluated. Information regarding perioperative outcomes and lymphadenectomy details was collected and analyzed, and their impact on OS, CSS, and DFS was assessed.
During the period under review, 323 patients with stage cI lung cancer underwent lobectomy with lymphadenectomy. Statistical analysis showed that the evaluated lymph nodal factors (mean number of lymph nodes removed and number and type of lymph node station explored) did not statistically significantly impact OS, CSS, and DFS at a median follow-up of 59 months (IQR 45-71).
The results of this study suggest that a less invasive procedure than systematic lymphadenectomy could be performed in early-stage cases with adequate preoperative staging.
淋巴结清扫术被认为是可切除肺癌根治性治疗的关键部分，尽管由于文献研究的巨大异质性，其在早期阶段的适当扩展仍是一个有争议的话题。本研究旨在评估淋巴结清扫范围对接受肺叶切除术和淋巴结清扫术的早期非小细胞肺癌患者生存和复发的影响。
回顾性评估2016年至2019年在两个胸外科中心接受肺叶切除术和肺门纵隔淋巴结清扫术的临床I期非小细胞肺癌患者的数据。收集并分析围手术期结果和淋巴结清扫细节的信息，并评估它们对总生存期（OS）、癌症特异性生存期（CSS）和无病生存期（DFS）的影响。
在审查期间，323例I期肺癌患者接受了肺叶切除术和淋巴结清扫术。统计分析表明，在中位随访59个月（四分位间距45 - 71）时，评估的淋巴结因素（切除的淋巴结平均数量以及探查的淋巴结站数量和类型）对OS、CSS和DFS没有统计学上的显著影响。
本研究结果表明，在术前分期充分的早期病例中，可以采用比系统性淋巴结清扫术侵入性更小的手术。
