Author of

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12534

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    P3.07-039 - Video-assisted mediastinoscopic lymphadenectomy is associated with better survival than mediastinsocopy in patients with operable and inoperable non-small cell lung cancer patients. (ID 2934)

    09:30 - 09:30  |  Author(s): S. Ozkul
    • Abstract

    Background
    Video-assisted mediastinoscopic lymphadenectomy (VAMLA) has been developed to reduce the false-negativity rate of mediastinoscopy. We aimed to analyze the impact of VAMLA on survival in patients with operable IA-IIIA disease and inoperable IIIB (N2) tumor.

    Methods
    Between May 2005 and June 2013, 421 N2 patients with non-small cell lung cancer who had undergone standard mediastinoscopy or VAMLA were evaluated. Of these, 105 patients (24.9%) underwent VAMLA, whereas 316 patients (75.1%) underwent standard mediastinoscopy. The median number of resected lymph node was 29.1 in VAMLA group , while the median was 10.3 in mediastinoscopy group.All patients with N2 disease were referred to medical oncology and/or radiation oncology departments. The survival rates were calculated using Kaplan-Meier test. Of those, 26 patients (6.2%) were referred to neoadjuvant treatment.

    Results
    The 5-year survival rate of N2 patients who had VAMLA was 34.0%, whereas it was 18.0% in patients who underwent mediastinoscopy (p=0.03)in all patients. Survival analyses revealed T factor (p=0.04), N factor (p=0.01), multiplicity of nodal status(p=0.04), and lymphatic invasion (p=0.03), type of mediastinoscopy (VAMLA vs standard mediastinoscopy) statistically significant in entire study population. Multivariable Cox analysis confirmed N stage(p=0.01, hazard ratio, 4.1, 95% confidence interval;1.125-8.661)T stage (p=0.045, hazard ratio, 1.4, 95% confidence interval: 1.050-4.112)and type of mediastinoscopy as independent prognostic factors (p=0.02, hazard ratio, 2.1; 95% confidence interval:1.11-11.03)

    Conclusion
    VAMLA seemed to provide longer survival in operable and inoperable (T3-4N2) non-small cell lung cancer patients. This effect could be due to complete resection of mediastinal lymph nodes. Further studies in order to clarify the possible survival impact are warranted.