ArticleJournal of thoracic disease2025
Mediastinal lymph node dissection in T1 stage lung adenocarcinoma: a retrospective analysis of survival outcomes and prognostic factors from the SEER database.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: There is no consensus on whether a thorough mediastinal lymph node dissection (MLND) is necessary for stage I lung adenocarcinoma (AD) patients who require lobectomy. This study aimed to evaluate the survival impact of MLND in patients with T1 stage lung AD undergoing lobectomy. Methods: We conducted a retrospective cohort study of 5,398 patients diagnosed with lung AD (tumor diameter 1-29 mm) from 2004 to 2015, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) program. Patients were treated with either lobectomy only or lobectomy with MLND. The primary endpoint was overall survival (OS), analyzed using Kaplan-Meier survival analysis, Chi-squared testing, and Cox regression analysis. Results: At a median follow-up of 97 months, the median survival duration for patients with T1a lung AD who underwent lobectomy with MLND was significantly longer (143 months), compared to those who underwent lobectomy alone (79 months, P<0.001). Similar survival benefits were found for T1b and T1c lung AD. Multivariate analysis revealed that lobectomy with MLND was an independent prognostic factor for patients with T1 stage lung AD [hazard ratio (HR) =0.731; 95% confidence interval (CI): 0.639-0.837; P<0.001]. Other significant prognostic factors included gender, age, N stage, and treatment modalities. Conclusions: Our findings suggest that MLND significantly improves survival in patients with T1 stage lung AD, highlighting its importance as a surgical strategy. Further prospective randomized controlled trials are needed to confirm these findings.
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