Can Lobe-specific Lymph Node Dissection Be an Alternative to Systematic Lymph Node Dissection in Treating Early-Stage Non-Small Cell Lung Cancer? A Comprehensive Systematic Review and Meta-Analysis

Han-yu Deng, Qinghua Zhou, Yidan Lin

west china hospital, sichuan university, chengdu, China

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–C

Abstract

Objectives: Whether lob-specific lymph node dissection (L-SLND) could serve as an alternative to systematic lymph node dissection (SLND) in treating early-stage non-small cell lung cancer (NSCLC) remains unclear. Therefore, we conducted this comprehensive meta-analysis to compare L-SLND with SLND in treating early-stage NSCLC.

Methods: A systematic literature search in PubMed and Embase was conducted to identify relevant studies up to 30 November 2017. Data including 5-year overall survival (OS) and disease-free survival (DFS) rates, recurrence rates, and morbidity rate were extracted and analysed.

Results: A total of six studies (one randomized controlled trial and five cohort studies) consisting of2037 patients with early-stage NSCLC were included for analysis. Meta-analysis showed that there was no significant difference of 5-year OS (81.7% and 79.5%, respectively; Risk ratio (RR)=1.021; 95%confidence interval (CI)= [0.977, 1.068]; P=0.352) and 5-year DFS (76.4% and 69.9%, respectively; RR=1.061; 95%CI= [0.999, 1.128]; P=0.054) between patients treated with L-SLND and those with SLND. Moreover, there was also no significant difference oftotal recurrence rate (24.3% and 25.8%, respectively; RR=0.892; 95%CI= [0.759, 1.048]; P=0.166) and loco-regional recurrence rate (7.9% and 9.3%, respectively; RR=0.851; 95%CI= [0.623, 1.162]; P=0.310) between patients treated with L- SLND and those with SLND. However, patients treated with L-SLND yielded significant lower rate of morbidity than those treated with SLND (10.2% and 13.5%, respectively; RR=0.681; 95%CI= [0.521, 0.888]; P=0.005).

Conclusion:L-SLND yielded significantly less risk of morbidity compared to SLND without compromising long-term oncologic outcomes. L-SLND could serve as an alternative to SLND in treating early-stage NSCLC.