2024 World Conference on Lung Cancer (WCLC) - Posters-P2.07B.10 Should Lymph Node Dissection Be Routinely Undertaken for Patients with Small-Sized Solid-Dominant Non-Small-Cell Lung Cancer?

P2.07B.10 Should Lymph Node Dissection Be Routinely Undertaken for Patients with Small-Sized Solid-Dominant Non-Small-Cell Lung Cancer?

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This study evaluates whether lymph node dissection (LND) should be routinely performed in patients with small-sized solid-dominant non-small-cell lung cancer (NSCLC), particularly with tumors measuring 2 cm in diameter and containing ground-glass opacity (GGO) components. The research involved analyzing 903 eligible patients who underwent surgical resection for primary lung cancer between 2017 and 2022.<br /><br />Recent clinical trials indicated that sublobar resection (including segmentectomy and wedge resection) might be non-inferior to lobectomy for overall survival in patients with small-sized early-stage NSCLC. These findings sparked an interest in optimizing surgical approaches, specifically regarding the extent of lung resection and LND.<br /><br />Key findings of the study include:<br /><br />1. **Low Incidence of LN Metastasis**: Patients with part-solid tumors experienced LN metastasis at a low rate (1.9%), suggesting that such patients might not significantly benefit from routine LN dissection during surgery.<br /><br />2. **Extending Wedge Resection Indications**: Considering the rarity of nodal involvement in small-sized part-solid NSCLC, the study suggests that wedge resection without mediastinal LND could be a sufficient surgical approach for these patients.<br /><br />3. **Prognosis and Recurrence**: Prognosis did not significantly differ with varying extents of sublobar resection. This supports the notion that less invasive surgeries like wedge resections might offer similar survival outcomes while sparing patients from the potential complications associated with more extensive LND.<br /><br />Overall, the study concludes that for small-sized part-solid NSCLC, the omission of mediastinal LND may be feasible, potentially allowing for less invasive surgical procedures without compromising prognosis. Further research is recommended to validate these findings and refine surgical guidelines.

Asset Subtitle

Naoyuki Oka

Meta Tag

Speaker Naoyuki Oka

Topic Early-Stage NSCLC

Keywords

lymph node dissection

NSCLC

sublobar resection

lobectomy

wedge resection

segmentectomy

LN metastasis

ground-glass opacity

prognosis

surgical guidelines