72 120

Cited 0 times in

Clinical Benefits of Lobe-Specific Lymph Node Dissection in Surgery for NSCLC: A Systematic Review and Meta-Analysis

 Wongi Woo  ;  Jae Il Shin  ;  Vincent Kipkorir  ;  Young Ho Yang  ;  Sungsoo Lee  ;  Chang Young Lee 
 JTO Clinical and Research Reports, Vol.4(5) : 100516, 2023-04 
Journal Title
JTO Clinical and Research Reports
Issue Date
Lung cancer ; Lymph node dissection ; Non–small cell lung cancer ; Surgery
Introduction: The impact of lobe-specific lymph node dissection (LS-LND) in surgery for NSCLC remains controversial compared with that of systematic lymph node dissection (S-LND). This study aimed to compare clinical outcomes between the two strategies, including postoperative complications, and to explain the advantages of LS-LND.

Methods: We searched for studies comparing LS-LND and S-LND up to April 14, 2022, using PubMed, EMBASE, and Web of Science. The primary outcomes were overall survival and recurrence-free survival. Secondary outcomes included postoperative complications, such as arrhythmia, chylothorax, and pneumonia. We evaluated the risk of bias and assessed the evidence quality using GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Results: A total of 13 studies, including one randomized controlled trial and 12 retrospective studies with 11,522 patients who underwent curative resections for lung cancer, were included. The results indicated that LS-LND had favorable overall survival (hazard ratio [HR] = 0.80, 95% confidence interval [CI]: 0.73-0.87) but no difference in recurrence-free survival (HR = 0.96, 95% CI: 0.84-1.09) on comparison with S-LND. In terms of postoperative complications, patients undergoing LS-LND had a lower rate of chylothorax (risk ratio [RR] = 0.54, 95% CI: 0.35-0.85) and arrhythmia (RR = 0.74, 95% CI: 0.57-0.97) than patients undergoing S-LND, but the risk of postoperative pneumonia was not different. The overall quality of evidence was low to moderate owing to the risk of bias related to heterogeneous study populations.

Conclusions: Patients undergoing LS-LND had a comparable and favorable long-term prognosis and a lower rate of postoperative complications. Nevertheless, further standardized studies are necessary to improve the quality of evidence.
Files in This Item:
T202303054.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Yang, Young Ho(양영호)
Woo, Wongi(우원기) ORCID logo https://orcid.org/0000-0002-0053-4470
Lee, Sung Soo(이성수) ORCID logo https://orcid.org/0000-0001-8998-9510
Lee, Chang Young(이창영)
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.