NSCLC: Bilateral Mediastinal Lymphadenectomy of Left Lobe Improves Survival
Researchers randomly assigned 89 patients with NSCLC to the SLND arm, in which patients underwent standard lung resection with SLND, or to the BML arm, in which patients received SLND plus contralater
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Removal of the contralateral mediastinal lymph nodes may provide a survival benefit among patients with non–small cell lung cancer (NSCLC) in the left lower lobe, according to a study presented at the International Association for the Study of Lung Cancer (IASLC) 18th Annual World Conference on Lung Cancer (WCLC) in Japan.1
Researchers randomly assigned 89 patients with NSCLC to the systematic lymph node dissection (SLND) arm, in which patients underwent standard lung resection with SLND, or to the bilateral mediastinal lymphadenectomy (BML) arm, in which patients received SLND plus contralateral mediastinal lymphadenectomy. There were no significant differences in patient baseline characteristics between the treatment arms. The mean follow-up period was 66.5 months.
Patients in the BML arm had a significantly higher 4-year survival rate of 72.5% compared with 51% in the SLND arm (P = .039).
Separate comparisons for various NSCLC-affected lobar regions revealed no significant differences in the 4-year survival rate and mean survival time among patients with tumors located in the right lung or left upper lobe.
Patients in the BML arm with NSCLC affecting the left lower lobe had a significantly greater 4-year survival rate (90.9% vs 25%; P = .003) and median survival time (1923 days vs 1244 days; P = .027) compared with patients in the SLND arm.
The authors concluded that a survival benefit was observed in patients with NSCLC in the lower left lobe who underwent BML, but noted that “these results should be confirmed in larger studies.”
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- Kuzdzal J, Hauer L, Hauer J, et al. Randomised trial of systematic lymph node dissection versus bilateral mediastinal lymphadenectomy in patients with non-small cell carcinoma. Presented at: International Association for the Study of Lung Cancer 18th World Conference on Lung Cancer; October 2017; Yokohama, Japan. Abstract OA 04.01.