Role of Lymph Node Dissection in Commonly Diagnosed Solid Organ Malignancies With High Mortality Rates: A Systematic...

Area of Science:

• Oncology
• Surgical Oncology
• Clinical Research

Background:

• Lymph node dissection (LND) is a common procedure in cancer treatment.
• The role of LND, including extended lymphadenectomy (ELND) versus standard lymphadenectomy (SLND), in improving survival for solid malignancies requires clarification.

Purpose of the Study:

• To review and compare the outcomes of lymph node dissection (LND) versus no LND, and ELND versus SLND in high-mortality solid tumors.
• To assess the impact of LND on overall survival, progression-free survival, and complications.

Main Methods:

• Systematic literature review of randomized controlled trials.
• Searched Medline, Embase, and Cochrane Library for studies on prostate, bladder, lung, breast, colorectal, pancreas, liver, endometrial, ovarian, and esophageal cancers.
• Primary endpoint: overall survival; Secondary endpoints: progression-free survival and complications.

Main Results:

• Of 43 eligible trials, 31 compared LND vs. no LND, and 12 compared ELND vs. SLND.
• No significant difference in overall or recurrence-free survival was found between LND and no LND, or between ELND and SLND, except for one breast cancer study showing improved survival with ELND.
• ELND may be associated with increased complications compared to SLND.

Conclusions:

• LND does not appear to improve survival outcomes for most common solid malignancies.
• The findings may aid in patient counseling regarding the role of LND in disease staging rather than survival.
• Further research is warranted to understand the impact of lymph node metastasis on cancer outcomes.