The Minimally Invasive Research Of Mediastinal Nodal Dissection For Non-small-cell Lung Cancer

Obiective:To evalute the results of two styles of mediastinal nodal dissection for early non-small-cell lung cancer(NSCLC).Methods:Patients with clinical N0/N1nonsmall-cell lung cancer（NSCLC） staged with CT scans and (or) PET scans who have underwent lobectomy between March2012and June2014were identified.Disease involvement of resected nodal stations was recorded,the purpose of which is to conclude the metastasis frequency and pattern of mediastinal nodal. In addition,the long-term outcome of thepatients who underwent lobectomy with complete systematic lymphnode dissection(CSLND) were compared with those who underwentselective lymph node dissection(SLND).Results:From March2012to June2014,122patients were identified.CSLND was performed in82patients,SLND was performed in40patients.11patients(13.4%) in the group with CSLND were found tohave N2disease after pathologic evaluation.Patients with adenocarcinoma were more likely to have pathologic N2disease than were p atients with other pathology.Only one patient (1.2%) had positive N2disease in the distal mediastinum while skipping lobe-specfic mediastinal nodes.Furthermore,patients with SLND had a similar rate ofrecurrence（19.5%vs20.0%,p=0.95),mortality（22.0%vs15.0%,p=0.37),disease-free survival（p=0.92）and overall survival（p=0.31).Conclusion:Mediastinal N2metastases follow predictable lobe-specfic patterns in patients with negative preoperative CT scans and PET scans.SLND results in a similar rate of recurence and overall survival to that of CSLND. SLND appears acceptable in patients with early-stage NSCLC whose pathological type is not glandular cancer.