Nodal Involvement Pattern in Clinical Stage IA Non-Small Cell Lung Cancer According to Tumor Location

• Main Authors: Meng S, Liu G, Wang S, Yang F, Wang J
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-08-01
• Series: Cancer Management and Research
• Subjects: non-small cell lung cancer; clinical stage ⅰa; lymph node dissection; nodal involvement pattern
• Online Access: https://www.dovepress.com/nodal-involvement-pattern-in-clinical-stage-ia-non-small-cell-lung-can-peer-reviewed-article-CMAR

Shushi Meng, Ganwei Liu, Shaodong Wang, Fan Yang, Jun Wang Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, People’s Republic of ChinaCorrespondence: Shaodong Wang; Jun WangDepartment of Thoracic Surgery, Peking University People’s Hospital, No. 11, Xizhimen South Street, Beijing 100044, People’s Republic of ChinaTel [phone]; [phone]Email [e-mail]; [e-mail]: The purpose of this study was to investigate lymph node involvement pattern in clinical stage IA non-small cell lung cancer (NSCLC).Patients and Methods: Clinical stage ⅠA NSCLC patients who underwent lobectomy and lymph node resection were included in this retrospective study. Mediastinal lymph node involvement was distinguished by different lobes and tumor size.Results: From 2000 to 2015, a total of 759 patients were identified: 282 (37.2%) with tumors in the right upper lobe (RUL), 183 (24.1%) in the left upper lobe (LUL), 124 (16.3%) in the right lower lobe (RLL), 103 (13.6%) in the left lower lobe (LLL), and 67 (8.8%) in the right middle lobe (RML). Patients with tumor size ≤ 1 cm accounted for 19.6%, > 1 and ≤ 2 cm for 47.8%, > 2 and ≤ 3 cm for 32.5%. Patients with pN1 accounted for 8.2%, and pN2 for 12.5%. Among patients with pN2, the inferior mediastinum was involved in 9.7% of RULs and 17.4% of LULs; the superior mediastinum was involved in 52.2% of RLLs and 36.4% of LLLs. Mediastinal lymph node metastasis was found in 13.2% of patients with size > 1 and ≤ 2 cm, and 19.0% of > 2 and ≤ 3 cm. Patients with tumors ≤ 1 cm had no N2 lymph node involved.Conclusion: Selective lymph node dissection based on tumor location is not recommended in clinical stage ⅠA NSCLC, and systemic lymph node dissection should be performed for NSCLC with size > 1 cm.Keywords: non-small cell lung cancer, clinical stage ⅠA, lymph node dissection, nodal involvement pattern