초록접수 현황
| 14F-054 | 포럼 발표 |
The Prognostic Implication of Presence of Metastasis to the Lymph Nodes in the Ipsilateral Different Lobes after Curative Resection for NSCLC
염상윤, 이현주, 박인규, 강창현, 김영태
서울대학교 의과대학 서울대학교병원 흉부외과학교실
Background : During the lung cancer surgery, lymph nodes of ipsilateral different lobes (IDL) were often harvested. However, the clinical significance of metastasis in those lymph nodes is not known. The aim of this study is to evaluate the prognostic significance of the lymph node metastases in the IDL.
Methods : Between 2000 and 2011, 2361 patients underwent surgery for NSCLC. A total of 1983 patients were selected by excluding patients who received induction therapy or who underwent incomplete resection, or who had pN3 stage. Survival data were analyzed using a Kaplan-Meier methods and a Cox’s proportional hazard model.
Results : Lymph nodes of IDL were sampled in 618 patients (primary mass location; RUL 149, RML 50, RLL 205, LUL 145, and LLL 69 patients). Metastases in IDL lymph nodes were present in 41 patients (6.7%). Patients were classified as group 1, if the IDL lymph nodes were sampled and were negative; group 2, if no lymph node of IDL was sampled; group 3, if the IDL lymph nodes harbored metastasis. Multivariate analysis revealed the status of IDL lymph nodes remained as an independent variable, which affected disease-free survival along with other prognostic factors such as age, gender, TNM status, and the extent of resection (Table 1). Kaplan-Meier analysis showed disease-free survival of pN1 patients who had metastatic lymph nodes in IDL was inferior to those who were pN1 and had not IDL metastasis (p=0.009), and it was similar to that of pN2 patients. (p=0.174, Figure 1)
Conclusion : We found metastasis to the IDL lymph nodes was observed in 6.7% of patients, and it seems to be a prognostic factor. Our results suggested that intraoperative lymph node sampling of the different lobes is necessary for accurate estimation of prognosis after resection of NSCLC.
Methods : Between 2000 and 2011, 2361 patients underwent surgery for NSCLC. A total of 1983 patients were selected by excluding patients who received induction therapy or who underwent incomplete resection, or who had pN3 stage. Survival data were analyzed using a Kaplan-Meier methods and a Cox’s proportional hazard model.
Results : Lymph nodes of IDL were sampled in 618 patients (primary mass location; RUL 149, RML 50, RLL 205, LUL 145, and LLL 69 patients). Metastases in IDL lymph nodes were present in 41 patients (6.7%). Patients were classified as group 1, if the IDL lymph nodes were sampled and were negative; group 2, if no lymph node of IDL was sampled; group 3, if the IDL lymph nodes harbored metastasis. Multivariate analysis revealed the status of IDL lymph nodes remained as an independent variable, which affected disease-free survival along with other prognostic factors such as age, gender, TNM status, and the extent of resection (Table 1). Kaplan-Meier analysis showed disease-free survival of pN1 patients who had metastatic lymph nodes in IDL was inferior to those who were pN1 and had not IDL metastasis (p=0.009), and it was similar to that of pN2 patients. (p=0.174, Figure 1)
Conclusion : We found metastasis to the IDL lymph nodes was observed in 6.7% of patients, and it seems to be a prognostic factor. Our results suggested that intraoperative lymph node sampling of the different lobes is necessary for accurate estimation of prognosis after resection of NSCLC.
책임저자: 김영태
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 염상윤, Tel: 02-2072-2343 , E-mail : skynsea424@gmail.com
