Comparison between lymph and non-lymph node resection in patients with stage IA non-small-cell lung cancer: A retrospective study.

Abstract

Objective: This retrospective study aimed to determine the need for lymph node resection during surgical treatment in patients with stage IA non-small-cell lung cancer (NSCLC).

Materials and methods: A total of 1428 patients diagnosed with cT1N0M0 1 A stage NSCLC who underwent surgery were divided into two groups: lymphadenectomy (n = 1324) and nonlymphadenectomy (n = 104). The effects of lymph node resection on overall survival (OS) and recurrence-free survival (RFS) and on clinicopathological factors that affected the prognosis of the patients were investigated.

Results: The group that underwent lymph node resection had a better 5-year OS (89.2% vs 81.1%) and 3-year RFS (87.6% vs 79.2%) than the one that did not. Multivariate Cox regression analysis revealed that the risk of OS in the nonlymphadenectomy group increased by 72% compared to that in the lymphadenectomy group [hazard ratio (HR), 1.72; 95% confidence interval (CI), 1.08-2.74; P < 0.05]. The risk of RFS in the group without lymphadenectomy increased by 45% compared to that in the group with lymphadenectomy (HR, 1.45; 95% CI, 0.98-2.14;P = 0.06). Significant reductions in the OS (HR, 5.90; 95% CI, 1.80-20.00; P < 0.005) and RFS (HR, 4.00; 95% CI, 1.50-11.00;P < 0.005) can be seen in the absence of lymph node resection in NSCLC patients with emphysema.

Conclusion: A thorough evaluation and removal of the hilar and mediastinal lymph nodes may prove useful in determining the cancer stage and assessing the need for further treatment, thus enhancing the prognosis of patients with stage IA NSCLC.