The standard lymph node dissection for non-small cell lung cancer (systematic lymph node dissection) does not include ipsilateral lobar lymph node dissection of the remaining lobe. Ipsilateral lobar lymph node dissection includes the dissection of all lobar lymph nodes on the side of the primary tumor, which are located along the lobar bronchi from the ostium of the lobar bronchi to that of the segmental ones.

OBJECTIVE

To investigate the impact of ipsilateral lobar lymph node dissection on survival.

MATERIAL AND METHODS

Examinations were made in 40 patients in the study group and in 40 ones in the control group who were diagnosed with non-small cell lung cancer and were to undergo radical surgical treatment. The study group underwent ipsilateral lobar lymph node dissection: with lobectomy of the remaining lobes and with pulmonectomy on a gross specimen after surgery. Adjuvant therapy results and 3-year overall and relapse-free survival rates were analyzed in each group.

RESULTS

The analysis of lymph node dissection and histopathological examination of the removed lymph nodes revealed ipsilateral lobar lymph node involvement in 14 (35%) of the 40 patients in the study group. In the latter, the authors identified a subgroup of patients with affected ipsilateral lobar lymph nodes, in which 12 patients received adjuvant chemotherapy. The overall 3-year survival rates were 70.0±14.49% in the study group (n=40) and 57.5±12.57% in the control group (n=40); (t=1.17; p=0.7); the 3-year disease-free survival rates were 45.0±15.73% (n=40) and 32.5±13.78% (n=40), respectively (t=1.32; p=0.8). In the study group, the best overall 3-year and disease-free survival rates were associated with ipsilateral lobar lymph node dissection and subsequent adjuvant chemotherapy.

CONCLUSION

Dissection of the ipsilateral lobar lymph nodes showed that the latter were affected; moreover, subsequent adjuvant therapy improved overall and relapse-free survival.