2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07C.03 Oncological Outcomes after Lobe-Specific Mediastinal Lymph Node Dissection in Thoracoscopic Right Upper Lobectomy for Clinical N0 NSCLC

EP.07C.03 Oncological Outcomes after Lobe-Specific Mediastinal Lymph Node Dissection in Thoracoscopic Right Upper Lobectomy for Clinical N0 NSCLC

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The study aimed to evaluate the effectiveness of lobe-specific mediastinal lymph node dissection (MLND) during thoracoscopic right upper lobectomy in early-stage non-small cell lung cancer (NSCLC) patients with clinical N0 staging. Conducted at the Cancer Institute Hospital of JFCR, Japan, it included 370 out of 802 right upper lobectomy patients reviewed from a total of 2880 individuals treated between 2008 and 2018.<br /><br />Lobe-specific MLND, particularly focusing on station 4R lymph nodes due to their proximity to tumors in the right upper lobe, was evaluated for providing precise staging and potential survival benefits. This retrospective study excluded patients with multiple lung cancers, cN1 and cN2 stages, and those who did not undergo lobe-specific MLND.<br /><br />Results indicated favorable outcomes with a safe profile, as evidenced by no conversions to thoracotomy, low operative blood loss, and no 30-day postoperative mortality among the 370 patients. The majority of participants showcased stage IA (79%) disease with adenocarcinoma being the predominant histological type (91%). The nodal upstaging rate was 8.1%, with 9.5% of patients experiencing recurrence during follow-ups, most commonly local recurrences.<br /><br />The retrograde pericardial exposure technique enabled a precise dissection without residual lymph nodes at station 4R, helping to reduce recurrence at the pulmonary hilum and mediastinal zones. Nevertheless, the study acknowledged the need for further investigation on the impact of molecular-targeted therapies and immune checkpoint inhibitors.<br /><br />In conclusion, the study supports the safety and oncologic efficiency of lobe-specific MLND using the retrograde pericardial technique in thoracoscopic right upper lobectomy for NSCLC, while highlighting future directions for improving outcomes with advanced pharmacological interventions.

Asset Subtitle

Mingyon Mun

Meta Tag

Speaker Mingyon Mun

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

lobe-specific MLND

thoracoscopic right upper lobectomy

non-small cell lung cancer

NSCLC

station 4R lymph nodes

retrograde pericardial exposure

adenocarcinoma

nodal upstaging

recurrence

molecular-targeted therapies