Abstract
BackgroundAlthough lobectomy with mediastinal lymph node dissection (MLND) is the first option for early-stage non-small cell lung cancer (NSCLC) patients, the time trends of MLND in stage IA NSCLC patients who undergo a lobectomy are not clear still.MethodsWe included stage IA NSCLC patients who underwent lobectomy or lobectomy with MLND between 2003 and 2013 in the SEER database. The time trend of MLND was compared among patients who underwent a lobectomy.ResultsFor stage T1a patients, the lobectomy group and lobectomy with MLND group had no differences in postoperative overall survival (OS) (P = 0.34) or lung-cancer specific survival (LCSS) (P = 0.18) between 2003 and 2013. For stage T1b patients, the OS (P = 0.01) and LCSS (P = 0.01) were different between the lobectomy group and the lobectomy with MLND group in the period from 2003 to 2009; however, only OS (P = 0.04), not LCSS (P = 0.14), was different between the lobectomy group and the lobectomy with MLND group between 2009 and 2013. For T1c patients, the OS (P = 0.01) and LCSS (P = 0.02) were different between the two groups between 2003 and 2009 but not between 2009 and 2013 (P = 0.60; P = 0.39). From the Cox regression analysis, we found that the factors affecting OS/LCSS in T1b and T1c patients were age, sex, year of diagnosis, histology, and grade, in which year of diagnosis was the obvious factor (HR = 0.79, CI = 0.71–0.87; HR = 0.73, CI = 0.64–0.84).ConclusionsThere was a time trend in prognosis differences between the lobectomy group and lobectomy with MLND group for T1b and T1c stage NSCLC patients.
Highlights
Lung cancer still has the highest incidence among malignant tumours, and non-small cell lung cancer (NSCLC) is the most common type
Early-stage NSCLC patients have been recommended for lobectomy with mediastinal lymph node dissection (MLND) for years, recent studies have shown that the benefit of other lymph node treatments is not inferior to MLND [8,9,10]
For T1a NSCLC patients, in both the period between 2003 and 2008 (Fig. 1 a, b) and the period between 2009 and 2013 (Fig. 1 c, d), there was no significant difference in the overall survival (OS) and lung-cancer specific survival (LCSS) between the lobectomy group and the lobectomy with MLND group
Summary
We enrolled 8631 stage IA NSCLC patients who underwent lobectomy or lobectomy with MLND between 2003 and 2013 totally and grouped these patients into the lobectomy group and lobectomy with MLND group. For T1a NSCLC patients, in both the period between 2003 and 2008 (Fig. 1 a, b) and the period between 2009 and 2013 (Fig. 1 c, d), there was no significant difference in the OS (log-rank p = 0.34, p = 0.44) and LCSS (log-rank p = 0.18, p = 0.20) between the lobectomy group and the lobectomy with MLND group. Between 2003 and 2008, the survival statuses of the lobectomy group and lobectomy with MLND group was significantly different in T1b patients, in terms of both OS (Fig. 2 a, log-rank p = 0.01) and LCSS (Fig. 2 b, logrank p = 0.01). The factors affecting the LCSS of patients were age (HR = 1.03, 95% CI 1.02– 1.04, p = 0.01), sex (HR = 0.76, 95% CI 0.68–0.85, p = 0.01), year of diagnosis (HR = 0.73, 95% CI 0.64–0.84, p = 0.01),and grade (HR = 1.20, 95% CI 1.12–1.28, p = 0.01)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
