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E. Ersen
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-017 - Video-Assisted Mediastinoscopic Lymphadenectomy Decreases the Need for Lymph Node Dissection during Lobectomy in Lung Cancer Patients (ID 2933)
09:30 - 09:30 | Author(s): E. Ersen
- Abstract
Background:
Mediastinoscopy has been accepted as a gold standard in preoperative staging of patients with cT1-3N1-3M0 non-small cell lung cancer. However, video-assisted mediastinoscopic lymphadenectomy (VAMLA) has been shown to provide higher negative predictive value. We aimed to investigate the role of VAMLA on the need and time for lymph node dissection following anatomical resection in these patients.
Methods:
Between May 2005 and March 2014, 299 patients who have undergone lobectomy following mediastinoscopy or VAMLA were analyzed.One-hundred-four patients (34.8%) underwent VAMLA, wehereas 195 patients (65.2%) had standard mediastinoscopy. 245 patients (81.9%) underwent open lobectomy while 54 (8.1%) had videothoracoscopic lobectomy. The median and mean numbers of resected lymph node stations were 5 and 4.9 in the VAMLA group and 4 and 4.2 in the mediastinoscopy group.
Results:
The mean number of lymph nodes per biopsy specimen using standard mediastinoscopy was 11.0 (ranging 2 to 33), whereas it was 29.7(Ranging 16-110) using VAMLA (p<0.001). ,The negative predictive value, sensitivity, false-negative value, and accuracy of VAMLA were statistically higher in the VAMLA groups compared with those of standard mediastinoscopy. In the VAMLA group, lymph node dissection of stations 2R, 2L, 4R, 4L, 7, and 8 was achieved in 90 (86.5%), 61 (59.6%), 90 (86.5%), 88 (84.6%), 101 (97.1%), and 30 (28.8%) of the patients, respectively. In the standard mediastinoscopy group, 2R, 2L, 4R, 4L, 7, and 8 underwent biopsy in 101 (52.0%), 46 (23.7%), 145 (74.7%), 91 (46.9%), 157 (80.9%), and 0 of the patients, respectively. The difference was statistically significant (p < 0.001). The mean number of dissected mediastinal lymph nodes following pulmonary resection was 9.4 (ranging 0 to 32) or 4.4 (ranging, 0-11) in patients who underwent standard mediastinoscopy or VAMLA, respectively (p<0.001). A statistical difference was found when analyzing the VATS lobectomy patients (mean 8.6 vs 3.1 lymph nodes )(p<0.001). The time for lymph node dissection was also found to be shorter(p=0.02).
Conclusion:
VAMLA provides bilateral lymph node dissection before resectional surgery and it decreases the necessity of lymph node dissection and alleviates it during VATS and open lobectomies performed in non-small cell lung cancer patients.
