Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer.
Hiroaki KurodaJunji IchinoseKatsuhiro MasagoYusuke TakahashiTakeo NakadaMasayuki NakaoSakae OkumuraKohei HashimotoYosuke MatsuuraNoriaki SakakuraHirokazu MatsushitaMingyon MunPublished in: Medicina (Kaunas, Lithuania) (2021)
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.
Keyphrases
- small cell lung cancer
- end stage renal disease
- early stage
- free survival
- chronic kidney disease
- ejection fraction
- newly diagnosed
- lymph node
- advanced non small cell lung cancer
- metabolic syndrome
- peritoneal dialysis
- heart failure
- patient reported outcomes
- insulin resistance
- patient reported
- rectal cancer
- coronary artery disease
- big data
- young adults
- glycemic control
- left ventricular
- locally advanced