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Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer

Background and Objectives: Lobe-specific nodal dissection (L-SND) is currently acceptable for the dissection of early-stage non-small cell lung cancer (NSCLC) but not for cancers of more advanced clinical stages. We aimed to assess the efficacy of L-SND, compared to systemic nodal dissection (SND)....

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Autores principales: Kuroda, Hiroaki, Ichinose, Junji, Masago, Katsuhiro, Takahashi, Yusuke, Nakada, Takeo, Nakao, Masayuki, Okumura, Sakae, Hashimoto, Kohei, Matsuura, Yosuke, Sakakura, Noriaki, Matsushita, Hirokazu, Mun, Mingyon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709178/
https://www.ncbi.nlm.nih.gov/pubmed/34946309
http://dx.doi.org/10.3390/medicina57121365
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author Kuroda, Hiroaki
Ichinose, Junji
Masago, Katsuhiro
Takahashi, Yusuke
Nakada, Takeo
Nakao, Masayuki
Okumura, Sakae
Hashimoto, Kohei
Matsuura, Yosuke
Sakakura, Noriaki
Matsushita, Hirokazu
Mun, Mingyon
author_facet Kuroda, Hiroaki
Ichinose, Junji
Masago, Katsuhiro
Takahashi, Yusuke
Nakada, Takeo
Nakao, Masayuki
Okumura, Sakae
Hashimoto, Kohei
Matsuura, Yosuke
Sakakura, Noriaki
Matsushita, Hirokazu
Mun, Mingyon
author_sort Kuroda, Hiroaki
collection PubMed
description Background and Objectives: Lobe-specific nodal dissection (L-SND) is currently acceptable for the dissection of early-stage non-small cell lung cancer (NSCLC) but not for cancers of more advanced clinical stages. We aimed to assess the efficacy of L-SND, compared to systemic nodal dissection (SND). Materials and Methods: We retrospectively collected the clinical data of patients with carcinoembryonic antigen (CEA) abnormality who underwent complete resection of NSCLC via lobectomy or more in addition to either SND or L-SND at two cancer-specific institutions from January 2006 to December 2017. Results: A total of 799 patients, including 265 patients who underwent SND and 534 patients who underwent L-SND, were included. On multivariate analysis, thoracotomy, more than lobectomy, cN1-2, advanced pathological stage, adjuvant treatment, and EGFR or ALK were strongly associated with SND. No significant differences were found in overall survival, disease-free survival, and overtime survival after propensity adjustment (p = 0.09, p = 0.11, and p = 0.50, respectively). There were no significant differences in local (p = 0.16), regional (p = 0.72), or distant (p = 0.39) tumor recurrence between the two groups. Conclusions: SND did not improve the prognosis of NSCLC patients with CEA abnormality. Complete pulmonary resection via L-SND seems useful for NSCLC patients with CEA abnormality.
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spelling pubmed-87091782021-12-25 Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer Kuroda, Hiroaki Ichinose, Junji Masago, Katsuhiro Takahashi, Yusuke Nakada, Takeo Nakao, Masayuki Okumura, Sakae Hashimoto, Kohei Matsuura, Yosuke Sakakura, Noriaki Matsushita, Hirokazu Mun, Mingyon Medicina (Kaunas) Article Background and Objectives: Lobe-specific nodal dissection (L-SND) is currently acceptable for the dissection of early-stage non-small cell lung cancer (NSCLC) but not for cancers of more advanced clinical stages. We aimed to assess the efficacy of L-SND, compared to systemic nodal dissection (SND). Materials and Methods: We retrospectively collected the clinical data of patients with carcinoembryonic antigen (CEA) abnormality who underwent complete resection of NSCLC via lobectomy or more in addition to either SND or L-SND at two cancer-specific institutions from January 2006 to December 2017. Results: A total of 799 patients, including 265 patients who underwent SND and 534 patients who underwent L-SND, were included. On multivariate analysis, thoracotomy, more than lobectomy, cN1-2, advanced pathological stage, adjuvant treatment, and EGFR or ALK were strongly associated with SND. No significant differences were found in overall survival, disease-free survival, and overtime survival after propensity adjustment (p = 0.09, p = 0.11, and p = 0.50, respectively). There were no significant differences in local (p = 0.16), regional (p = 0.72), or distant (p = 0.39) tumor recurrence between the two groups. Conclusions: SND did not improve the prognosis of NSCLC patients with CEA abnormality. Complete pulmonary resection via L-SND seems useful for NSCLC patients with CEA abnormality. MDPI 2021-12-14 /pmc/articles/PMC8709178/ /pubmed/34946309 http://dx.doi.org/10.3390/medicina57121365 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kuroda, Hiroaki
Ichinose, Junji
Masago, Katsuhiro
Takahashi, Yusuke
Nakada, Takeo
Nakao, Masayuki
Okumura, Sakae
Hashimoto, Kohei
Matsuura, Yosuke
Sakakura, Noriaki
Matsushita, Hirokazu
Mun, Mingyon
Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer
title Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer
title_full Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer
title_fullStr Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer
title_full_unstemmed Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer
title_short Permissible Outcomes of Lobe-Specific Lymph Node Dissection for Elevated Carcinoembryonic Antigen in Non-Small Cell Lung Cancer
title_sort permissible outcomes of lobe-specific lymph node dissection for elevated carcinoembryonic antigen in non-small cell lung cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709178/
https://www.ncbi.nlm.nih.gov/pubmed/34946309
http://dx.doi.org/10.3390/medicina57121365
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