초록접수 현황
| 20F-007 | 구연 발표 |
Clinical Significance of Regional Lymph Node Dissection during Sublobar Resection: A Propensity Score-Weighted Analysis
Jae Kwang Yun1, Geun Dong Lee1, Sehoon Choi1, Yong-Hee Kim1, Dong Kwan Kim1, Seung-Il Park1, and Hyeong Ryul Kim1.
¹Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Purpose : This study is aimed to evaluate the prognostic impact of lymph node dissection (LND) in non-small cell lung cancer (NSCLC) patients who received sublobar resection based on harvested node stations.
Methods : We retrospectively reviewed the data from NSCLC patients who underwent sublobar resection at Asan Medical Center between 2007 and 2016. To adjust for the differences in confounding variables between the groups, propensity score-based inverse probability of treatment weighting (IPTW) was carried out.
Results : Of the 634 patients, LND was performed in 547 patients (LND group, 86.3%), whereas it was not in 87 patients (Nx group, 13.7%). There was no significant difference of survival outcome between them (p = 0.395). Pathological N0 (pN0) patients who underwent both N1 and N2 LND (N1+N2 group) had better survival outcome than Nx group (p = 0.015) and patients who underwent only N2 LND (N2 only group) (p < 0.001). After IPTW adjustment, N1+N2 group still had better prognosis than N2 only group (p = 0.019), even in patients with tumor size ≤ 2cm (p = 0.032) or wedge resection (p = 0.041). According to IPTW-adjusted multivariable analysis, the performance of regional LND was a significant prognostic factor for survival outcome (hazard ratio (95% confidence interval) = 0.58 (0.35-0.95), p = 0.030).
Conclusion : LND is a critical process during sublobar resection in NSCLC patients. Although regional LND might require additional fissure division during sublobar resection, it is encouraged to achieve a thorough LN evaluation, facilitating proper postoperative treatment.
Methods : We retrospectively reviewed the data from NSCLC patients who underwent sublobar resection at Asan Medical Center between 2007 and 2016. To adjust for the differences in confounding variables between the groups, propensity score-based inverse probability of treatment weighting (IPTW) was carried out.
Results : Of the 634 patients, LND was performed in 547 patients (LND group, 86.3%), whereas it was not in 87 patients (Nx group, 13.7%). There was no significant difference of survival outcome between them (p = 0.395). Pathological N0 (pN0) patients who underwent both N1 and N2 LND (N1+N2 group) had better survival outcome than Nx group (p = 0.015) and patients who underwent only N2 LND (N2 only group) (p < 0.001). After IPTW adjustment, N1+N2 group still had better prognosis than N2 only group (p = 0.019), even in patients with tumor size ≤ 2cm (p = 0.032) or wedge resection (p = 0.041). According to IPTW-adjusted multivariable analysis, the performance of regional LND was a significant prognostic factor for survival outcome (hazard ratio (95% confidence interval) = 0.58 (0.35-0.95), p = 0.030).
Conclusion : LND is a critical process during sublobar resection in NSCLC patients. Although regional LND might require additional fissure division during sublobar resection, it is encouraged to achieve a thorough LN evaluation, facilitating proper postoperative treatment.
책임저자: Hyeong Ryul Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea.
발표자: Jae Kwang Yun, E-mail : janies@nate.com