(withdrawal) Consideration of the necessity of systematic lymph node dissection in case of unavoidable sublobar resection and intentional sublobar resection for early stage lung cancer

Hong Kwan Kim

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Purpose : In early lung cancer, lobectomy is the standard treatment, but there are cases where sublobar resection inevitably is performed due to patient’s poor condition. Or, although the patient's lung function is sufficient for pneumonectomy, sublobar resection is performed on purpose because it is judged to be a very early cancer. In the case of the former case, there is an opinion that it is empirical to perform systemic lymph node dissection (SLND) to bring about a better prognosis, and in the latter case it is considered that it may be omitted, but there is no decision as to in which case it may be omitted. Therefore, this study confirms the prognosis according to SLND in each of the intentional and inevitable group.

Methods : Of the 5914 patients who underwent surgery for lung cancer from 2012 to 2017, tumor size less than 3 cm, no history of cancer and whom was performed sublobar resecton. 503 people were selected, of which, if both preoperative Fev1 and DLCO were 80% or more, the intentional group (n=323), otherwise, the inevitable group (n=180), and systematic lymph node dissection. The prognosis was analyzed according to whether or not to perform SLND.

Results : There was no difference with SLND in both death and recurrence in both group

Conclusion : For early lung cancer, SLND in both the intentional group and the inevitable group does not have a significant effect on death and recurrence, so we think that it is possible to consider omitting SLND very selectively.

책임저자: Shin Kim

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

발표자: Shin Kim, E-mail : kimbelief@naver.com