NSCLC: better survival with LNE in sublobar resection

  • Yendamuri S & al.
  • J Thorac Cardiovasc Surg
  • 4 Apr 2018

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with early-stage NSCLC who underwent sublobar resection and had ≥1 lymph node examined (LNE) had better OS and disease-specific survival than those who had no LNEs.
  • Sublobar resection with anatomic segmentectomy yielded more lymph nodes for examination than wedge resection.

Why this matters

  • Even though increased lymph node examination confers a survival advantage, 49.5% of wedge resection patients and 23.5% of segmentectomy patients had no lymph node examination.

Study design

  • 3916 patients with early-stage NSCLC from the Surveillance, Epidemiology, and End Results database who underwent sublobar resection were analyzed.
  • Funding: None disclosed.

Key results

  • 18.5% underwent segmentectomy and 81.7% underwent wedge resection.
  • Only 50.5% of patients who had a wedge resection and 76.5% of patients who had a segmentectomy had at least 1 LNE at pathology.
  • Having ≥1 LNE was associated with better OS (OR, 0.66; P<.001 and disease-specific survival p>
  • After multivariable analysis, there were no differences in OS or disease-specific survival in patients who had ≥1 LNE, regardless of surgical approach.

Limitations

  • Retrospective study.

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