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Annals of Surgical Oncology

, Volume 25, Issue 11, pp 3300–3307 | Cite as

Incidence and Distribution of Lobe-Specific Mediastinal Lymph Node Metastasis in Non-small Cell Lung Cancer: Data from 4511 Resected Cases

  • Run-Bin Liang
  • Jie Yang
  • Tai-Shan Zeng
  • Hao Long
  • Jian-Hua Fu
  • Lan-Jun Zhang
  • Peng Lin
  • Xin Wang
  • Tie-Hua Rong
  • Xue HouEmail author
  • Hao-Xian YangEmail author
Thoracic Oncology

Abstract

Objective

We aimed to investigate the incidence and distribution of mediastinal lymph node metastases (MLNM) in operable non-small cell lung cancer (NSCLC) with the purpose of guiding mediastinal lymph node dissection (MLND).

Methods

A total of 4511 NSCLC patients who underwent resection between January 2001 and December 2014 were included. These patients were preoperatively untreated and grouped according to the primary tumor lobes. The incidence and distribution of pathologic MLNM were compared among groups, and multivariate analysis was conducted to find the independent factors impacting MLNM.

Results

Lymph node involvement was observed in 1784 patients (39.5%). A total of 628 cases (13.9%) were N1-positive only, 752 cases (16.7%) were both N1- and N2-positive, and 404 cases (9.0%) were N2-positive only. The most common sites of mediastinal metastasis for different primary tumor lobes were the right upper lobe, station 4R (21.5%, 192/893); right middle lobe, station 7 (21.1%, 69/327); right lower lobe, station 7 (24.1%, 212/878); left upper lobe, station 5 (22.2%, 224/1008); and left lower lobe, station 7 (21.7%, 136/628). However, when only N2 cases were considered, each mediastinal lymph node zone can be involved with metastasis to a high proportion (> 5%). Multivariable analyses showed that poor cell differentiation, adenocarcinoma, larger tumor size, central type, and younger age were independent factors favoring MLNM.

Conclusions

Different primary tumor locations have a different propensity to be sites of MLNM; however, once MLNM occurs, each zone can be involved and should not be neglected. Systematic MLND is the preferred procedure for operable NSCLC.

Notes

Acknowledgment

This work was supported by the Science and Technology Planning Project of Guangdong Province (2013B021800147), the Natural Science Foundation of Guangdong Province (2016A030313857), the Guangdong Provincial Medical Scientific Funds (2016114134515565), and the National Natural Science Foundation of China (81501986).

Disclousre

Run-Bin Liang, Jie Yang, Tai-Shan Zeng, Hao Long, Jian-Hua Fu, Lan-Jun Zhang, Peng Lin, Xin Wang, Tie-Hua Rong, Xue Hou, and Hao-Xian Yang have no conflicts of interest to disclose.

Supplementary material

10434_2018_6394_MOESM1_ESM.docx (65 kb)
Supplementary material 1 (DOCX 65 kb)

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Run-Bin Liang
    • 1
    • 2
    • 3
  • Jie Yang
    • 1
    • 2
    • 3
  • Tai-Shan Zeng
    • 4
  • Hao Long
    • 1
    • 2
    • 3
  • Jian-Hua Fu
    • 1
    • 2
    • 3
  • Lan-Jun Zhang
    • 1
    • 2
    • 3
  • Peng Lin
    • 1
    • 2
    • 3
  • Xin Wang
    • 1
    • 2
    • 3
  • Tie-Hua Rong
    • 1
    • 2
    • 3
  • Xue Hou
    • 2
    • 3
    • 5
    Email author
  • Hao-Xian Yang
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of Thoracic SurgerySun Yat-sen University Cancer CenterGuangzhou CityChina
  2. 2.State Key Laboratory of Oncology in South ChinaGuangzhou CityChina
  3. 3.Collaborative Innovation Center for Cancer MedicineGuangzhou CityChina
  4. 4.School of Mathematical SciencesSouth China Normal UniversityGuangzhou CityChina
  5. 5.Department of Medical OncologySun Yat-sen University Cancer CenterGuangzhou CityChina

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