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Updated: Oct 20, 2025
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
Mediastinal lymph node dissection in older patients with non-small cell lung cancer
Tomohiro Maniwa1,2, Toru Kimura3, Masayuki Ohue4
1Department of General Thoracic Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan. tomohiro.maniwa@oici.jp.
Purpose:
We evaluated the impact of omitting mediastinal lymph node dissection (MLND) from the surgical treatment of non-small cell lung cancer (NSCLC) in older patients.
Methods:
We collected data retrospectively on 2475 patients who underwent pulmonary resection for NSCLC at our hospital between June, 2006 and December 2018. The subjects of this analysis were 209 patients aged ≥ 75 years who underwent lobectomy for cN0-1 NSCLC. The patients were divided into two groups based on whether they underwent MLND (ND2 group) or not (group ND0-1).
Results:
There were more patients aged ≥ 80 years in the ND0-1 group than in the ND2 group (p < 0.001). Patients in the ND0-1 group had clinically earlier stage lung cancers than those in the ND2 group (p = 0.053). We matched patient characteristics in the ND0-1 and ND2 groups by age, tumor diameter, cN, histology, and radiological findings. There were no significant differences in overall survival between the groups (p = 0.295). More patients in the ND2 group suffered complications (41.6% vs. 27.3%, p = 0.061) and arrhythmia episodes than those in the ND0-1 group (14.3% vs. 3.9%, p = 0.021).
Conclusion:
MLND in older patients may not extend survival but it could lead to complications. Thus, the omission of MLND may be considered for patients of advanced age.
