WCLC 2025 - Posters & ePosters-P1.07.24 Radicality of Lymphadenectomy in NSCLC Resection: Impact on Survival. Results From the Spanish Video-Assisted Thoracic Surgery Group (GEVATS)

P1.07.24 Radicality of Lymphadenectomy in NSCLC Resection: Impact on Survival. Results From the Spanish Video-Assisted Thoracic Surgery Group (GEVATS)

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This prospective, multicenter study by the Spanish Video-Assisted Thoracic Surgery Group (GEVATS) investigated the impact of the radicality of lymphadenectomy on survival in patients undergoing anatomic pulmonary resection for non-small cell lung cancer (NSCLC). Data from 1548 patients treated between December 2016 and March 2018 were analyzed with follow-up completed in September 2022. Systematic nodal dissection (SND), defined as the removal or sampling of at least six lymph nodes including the subcarinal station, was performed in 60.3% of cases (933 patients); the remaining 615 had no systematic nodal dissection (No SND).<br /><br />The study examined overall survival (OS) and cancer-specific survival (CSS) relative to SND status. While in the overall cohort SND was not associated with improved OS or CSS, a survival benefit was observed in the subgroup of patients with pathological N1 (pN1) nodal status and tumors sized 3 cm or greater. For these patients, SND showed significantly better OS and CSS compared to those without SND. Multivariate analysis confirmed this association specifically for pN1 tumors ≥3 cm.<br /><br />Baseline patient characteristics, including age, gender, smoking status, pulmonary function tests, and tumor histology, were comparable between groups, though SND patients had a higher number of lymph nodes assessed (median 10 vs. 4). The study controlled for confounders using Cox regression, showing no survival differences with SND in pN0 or pN2 patients.<br /><br />The findings suggest that routine performance of systematic nodal dissection should be considered during NSCLC resections, particularly in patients with pN1 disease and larger tumors (≥3 cm), to improve survival outcomes. In patients with less advanced nodal disease or smaller tumors, the survival advantage of SND was not evident.<br /><br />In conclusion, the radicality of lymphadenectomy impacts survival selectively in NSCLC resections, supporting tailored surgical lymph node assessment to optimize oncologic outcomes.

Asset Subtitle

Carme Obiols

Meta Tag

Speaker Carme Obiols

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

NSCLC

systematic nodal dissection

SND

lymphadenectomy radicality

anatomic pulmonary resection

pathological N1 nodal status

tumor size ≥3 cm

overall survival

cancer-specific survival