Prognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancer
Abstract Background To investigate the prognostic significance of station 4R lymph node (LN) dissection in patients who underwent operations for right primary non-small cell lung cancer (NSCLC). Methods We performed a retrospective study involving patients with right primary NSCLC who received lobot...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-022-02689-w |
| _version_ | 1818533900517900288 |
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| author | Di Zhou Dongsheng Yue Zhenfa Zhang Pengfei Tian Yingnan Feng Zuo Liu Bin Zhang Meng Wang Xiaoliang Zhao Changli Wang |
| author_facet | Di Zhou Dongsheng Yue Zhenfa Zhang Pengfei Tian Yingnan Feng Zuo Liu Bin Zhang Meng Wang Xiaoliang Zhao Changli Wang |
| author_sort | Di Zhou |
| collection | DOAJ |
| description | Abstract Background To investigate the prognostic significance of station 4R lymph node (LN) dissection in patients who underwent operations for right primary non-small cell lung cancer (NSCLC). Methods We performed a retrospective study involving patients with right primary NSCLC who received lobotomy or pneumonectomy with mediastinal LN dissection between January 2011 and December 2017. Propensity score matching was performed. Disease-free survival (DFS) and overall survival (OS) were compared between patients with and without station 4R dissection. Results Our study included 2070 patients, with 207 patients having no station 4R dissection (S4RD− group) and 1863 patients having station 4R dissection (S4RD+ group). The 4R LN metastasis rate was 13.4% (142/1748), higher than that for other mediastinal LN metastases. Compared with the S4RD− group, the S4RD+ group had higher 5-year DFS (48.1% vs. 39.1%, P = 0.009) and OS (54.4% vs. 42.8%, P = 0.025). Station 4R dissection was an independent risk factor for DFS (odds ratio, OR, 1.28, 95% confidence interval, CI, 1.08–1.64, P = 0.007) and OS (OR 1.31, 95% CI 1.04–1.63, P = 0.018). Patients with adjuvant chemotherapy had a better prognosis after station 4R dissection than those without adjuvant chemotherapy (57.4% vs. 52.3%, P = 0.006). The 5-year OS in the station 4R metastasis group was lower than that in the station 4R non-metastasis group (26.9% vs. 44.3%, P = 0.006) among N2 patients. The 5-year OS of the single-station 4R metastasis group was lower than that of the single-station 7 metastasis group (15.7% vs. 51.6%, P = 0.002). Conclusions Station 4R metastasis was the highest among all the mediastinal station metastases in right primary NSCLC patients. Station 4R dissection can improve the prognosis and should be recommended as a routine procedure for these patients. |
| first_indexed | 2024-12-11T18:04:49Z |
| format | Article |
| id | doaj.art-6a77e243ebb24f45968e57e3bc566fcc |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-11T18:04:49Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-6a77e243ebb24f45968e57e3bc566fcc2022-12-22T00:55:46ZengBMCWorld Journal of Surgical Oncology1477-78192022-07-0120111110.1186/s12957-022-02689-wPrognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancerDi Zhou0Dongsheng Yue1Zhenfa Zhang2Pengfei Tian3Yingnan Feng4Zuo Liu5Bin Zhang6Meng Wang7Xiaoliang Zhao8Changli Wang9Department of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalDepartment of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and HospitalAbstract Background To investigate the prognostic significance of station 4R lymph node (LN) dissection in patients who underwent operations for right primary non-small cell lung cancer (NSCLC). Methods We performed a retrospective study involving patients with right primary NSCLC who received lobotomy or pneumonectomy with mediastinal LN dissection between January 2011 and December 2017. Propensity score matching was performed. Disease-free survival (DFS) and overall survival (OS) were compared between patients with and without station 4R dissection. Results Our study included 2070 patients, with 207 patients having no station 4R dissection (S4RD− group) and 1863 patients having station 4R dissection (S4RD+ group). The 4R LN metastasis rate was 13.4% (142/1748), higher than that for other mediastinal LN metastases. Compared with the S4RD− group, the S4RD+ group had higher 5-year DFS (48.1% vs. 39.1%, P = 0.009) and OS (54.4% vs. 42.8%, P = 0.025). Station 4R dissection was an independent risk factor for DFS (odds ratio, OR, 1.28, 95% confidence interval, CI, 1.08–1.64, P = 0.007) and OS (OR 1.31, 95% CI 1.04–1.63, P = 0.018). Patients with adjuvant chemotherapy had a better prognosis after station 4R dissection than those without adjuvant chemotherapy (57.4% vs. 52.3%, P = 0.006). The 5-year OS in the station 4R metastasis group was lower than that in the station 4R non-metastasis group (26.9% vs. 44.3%, P = 0.006) among N2 patients. The 5-year OS of the single-station 4R metastasis group was lower than that of the single-station 7 metastasis group (15.7% vs. 51.6%, P = 0.002). Conclusions Station 4R metastasis was the highest among all the mediastinal station metastases in right primary NSCLC patients. Station 4R dissection can improve the prognosis and should be recommended as a routine procedure for these patients.https://doi.org/10.1186/s12957-022-02689-wNon-small cell lung cancerRight primary lung cancerStation 4R lymph nodes |
| spellingShingle | Di Zhou Dongsheng Yue Zhenfa Zhang Pengfei Tian Yingnan Feng Zuo Liu Bin Zhang Meng Wang Xiaoliang Zhao Changli Wang Prognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancer World Journal of Surgical Oncology Non-small cell lung cancer Right primary lung cancer Station 4R lymph nodes |
| title | Prognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancer |
| title_full | Prognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancer |
| title_fullStr | Prognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancer |
| title_full_unstemmed | Prognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancer |
| title_short | Prognostic significance of 4R lymph node dissection in patients with right primary non-small cell lung cancer |
| title_sort | prognostic significance of 4r lymph node dissection in patients with right primary non small cell lung cancer |
| topic | Non-small cell lung cancer Right primary lung cancer Station 4R lymph nodes |
| url | https://doi.org/10.1186/s12957-022-02689-w |
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