![]() ![]() Furthermore, the sublevel dissection of lymph nodes could lead to the lower perioperative complications and morbidities in patients receiving selective LND, especially in elderly patients ( 7, 8). The American College of Surgery Oncology Group Z0030 study reported that no significant survival was observed between patients with early-stage NSCLC that received systematic LND and lymph node sampling. The new strategy of selective lymph node dissection (LND) has been considered for early-stage NSCLC. Although some studies reported no significant survival between standard lobectomy and sublobar resection ( 3, 4), the incidence rate of occult lymph node metastasis (LNM) was high in patients with T1a-b NSCLC ( 5, 6). Lobectomy with systematic lymph node dissection remains the standard treatment for NSCLC ≤ 2 cm ( 2), but sublobar resection (wedge resection and segmentectomy) and non-surgical treatment have attracted growing attention. Surgeons should be more careful when performing selective LND for tumors located in the lower and upper lobes.Īn increasing incidence of small-size non-small cell lung cancer (NSCLC) has been identified in recent years ( 1). Whether lobe-specific selective LND is suitable for all small-size patients deserves more studies to confirm. However, there were still a few patients (10.9%, 5/46) had the involvement of lower zone for tumors of upper lobe and the involvement of upper zone for lower lobe.Ĭonclusions: SN2 occurs frequently in patients with small-size NSCLC. For the tumor located in each lobe, specific nodal drainage stations were identified: 2R/4R for right upper lobe 2R/4R and subcarinal node (#7) for right middle lobe and right lower lobe 4L and subaortic node (#5) for left upper lobe #7 for left lower lobe. For all clinicopathological characteristics, no significant difference was observed among the groups of N1, SN2, and NSN2. Results: A total of 63 NSCLC patients with tumor size of 1–2 cm were staged as pN2, including 25 (39.7%) SN2 and 38 (60.3%) NSN2. Metastatic patterns of mediastinal lymph node were analyzed based on final pathology. Clinical, radiographical, and pathological characteristics were compared among N1, SN2, and NSN2 groups. Methods: We reviewed the records of NSCLC patients with tumor size of 1–2 cm who underwent lobectomy with systematic lymph node dissection (LND) between January 2013 and June 2019. This study aims to investigate clinicopathological characteristics associated with skip N2 (SN2) and non-skip N2 (NSN2) metastasis, and their metastatic patterns in NSCLC with tumor size of 1–2 cm. ![]() Fewer studies has focused on LNM in patients with small-size non-small cell lung cancer (NSCLC). 3Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, Chinaīackground: Lymph node metastasis (LNM) status is critical to the treatment.2Peking Union Medical College, Eight-year MD program, Chinese Academy of Medical Sciences, Beijing, China.1Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. ![]() Abbott, and Thomas W.Yijun Wu 1,2 †, Chang Han 2 †, Liang Gong 2, Zhile Wang 1,2, Jianghao Liu 2, Xinyu Liu 2,3, Xinyi Chen 2, Yuming Chong 2, Naixin Liang 1 * and Shanqing Li 1 *
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