早期肺癌特异性淋巴清扫的临床回顾研究

BACKGROUND AND OBJECTIVE: The aim of this study is to explore the effects of different modes of lymph node dissection in early-stage non-small cell lung cancer (NSCLC) on the survival rate, to study the prognostic factors, and to discuss the clinical application of lobe-specific lymph node dissection. METHODS: A total of 379 patients with completely resected pathological stage Ⅰ NSCLC between the years 1998 and 2005 at Shanghai Chest Hospital were retrospectively analyzed. Among the patients, 148 were placed in the systematic lymph node dissection group and 150 in the lobe-specific lymph node dissection group. All of them were in pathological stage Ⅰ (T1a-2aN0M0). The differences between the two groups were compared. RESULTS: No statistical difference was found between the two sets of data in terms of the clinical and pathological features of distribution (P > 0.05). The overall survival distribution between the two groups had no statistical difference (P > 0.05). The pathological stage, pathological type, and tumor size significantly differed between the two groups. The duration of surgery, blood loss, blood transfusion, drain secretion, duration of drainage, and duration of hospital stay also significantly differed between the two groups (P < 0.01). The complications significantly differed between the two groups as well (P < 0.05). CONCLUSION: Systematic lymph node dissection does not improve the five-year survival rates in pathological stage Ⅰ NSCLC. The pathological stage, pathological type, and tumor size critically affect the prognosis. Lobe-specific lymph node dissection can significantly reduce complications and perioperative risks.