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Effects of mediastinal lymph node dissection in colorectal cancer-related pulmonary metastasectomy

 Young Ho Yang  ;  Seong Yong Park  ;  Ha Eun Kim  ;  Byung Jo Park  ;  Chang Young Lee  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Hyo Chae Paik 
 THORACIC CANCER, Vol.12(23) : 3248-3254, 2021-12 
Journal Title
Issue Date
colorectal cancer ; mediastinal lymph node dissection ; overall survival ; pulmonary metastasectomy
Background: The benefits of mediastinal lymph node dissection (MLND) in colorectal cancer-related pulmonary metastasectomy (PM) have been poorly reported. This study aimed to determine whether MLND affects survival in patients undergoing PM and to identify the prognostic factors for survival.

Methods: We retrospectively reviewed 275 patients who had undergone colorectal cancer-related PM from January 2010 to December 2016. MLND was defined as the resection of at least six mediastinal lymph node stations according to the International Association for the Study of Lung Cancer criteria (N1, ≥3 stations; N2, ≥3 stations). The propensity score matching method was used to reduce bias.

Results: Thirty-three (12%) patients underwent MLND, and 13 (4.7%) patients had mediastinal lymph node involvement. This study showed no difference in 5-year overall survival (no MLND, 52.7% vs. MLND, 53.5%; p = 0.81). On multivariable analysis, negative prognostic factors for overall survival were preoperative carcinoembryonic antigen (CEA) level (p < 0.001), a higher number of metastatic nodules (p < 0.001), metastatic nodule size ≥2 cm (p < 0.001), and lymph node involvement (p = 0.006).

Conclusions: Mediastinal lymph node involvement, preoperative CEA level, higher metastatic nodule number, and nodule size negatively affected survival whereas MLND in PM was not associated with survival.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Kim, Ha Eun(김하은)
Park, Byung Jo(박병조)
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Yang, Young Ho(양영호)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
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