In a nutshell
This trial looked at the impact of complete lymph node dissection for patients with early stage non-small-cell lung cancer. They concluded that complete dissection of the mediastinal lymph nodes was associated with better survival rates compared to only removing a few lymph nodes for sampling.
Some background
Surgery to remove tumors is usually the first option for patients with early stage NSCLC. Because cancer can spread to other areas of the body, it is important to check other sites such as the lymph nodes. The lymph nodes nearest the lung are called mediastinal lymph nodes. Mediastinal lymph node dissection (MLND) is the complete removal of the mediastinal lymph nodes. Another techinique is mediastinal lymph node sampling (MLNS), which involves sampling the lymph nodes for cancer cells. It is not clear which is more beneficial for survival rates in NSCLC.
Methods & findings
This study aimed to determine the impact of MLND on long term survival among patients with stage 1 NSCLC. The study included 317 patients with stage 1 NSCLC who were followed for 10 years following surgery. 161 patients received surgery with MLND. 156 patients received surgery with MLNS.
Overall average survival was 146 months. The survival rate was 80.1% after 3 years, 68.5% after 5 years, and 54.6% after 10 years.
For patients who received MLND as part of their treatment, the survival rate was 83.2% after 3 years, 73.9% after 5 years and 57.8% after 10 years. For patients who received MLNS as part of their treatment, the survival rate was 76.9% after 3 years, 62.8% after 5 years and 51.3% after 10 years.
Overall, there was 36% greater mortality (death) in patients who received MLNS compared to those who received MLND. This was particularly specific to patients with tumors between 2 and 3 cm.
The bottom line
The authors concluded that MLND was associated with better survival for patients with early stage NSCLC.
Published By :
Medicine
Date :
Oct 01, 2017
