小外围肺癌中的淋巴结剖析:对JCOG0802/WJOG4607L的补充分析
Tomohiro Maniwa1, Jiro Okami1, Tomohiro Miyoshi2
1Department of Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan.
The Journal of thoracic and cardiovascular surgery
|November 24, 2023
概括
对于小肺癌,在细分切除术期间的淋巴结解剖应根据瘤类型而异. 对于纯固体瘤,建议选择性剖析,而对于部分固体瘤,广泛剖析几乎没有好处.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 肺部医学 肺部医学
背景情况:
- 小外围非小细胞肺癌 (NSCLC) 的细分切除过程中的最佳淋巴结解剖 (LND) 仍然不清楚.
- 以前的研究尚未完全阐明淋巴结转移 (LNM) 和基于瘤特征的复发的模式.
研究的目的:
- 调查在进行细分切除术的NSCLC患者中LNMs的因素,分布和复发模式.
- 根据放射性瘤发现,提出最佳的LND区域.
主要方法:
- 从JCOG0802/WJOG4607L试验中对1056名患者进行了补充分析.
- 研究与放射学发现相关的LNM分布和复发模式 (部分固体vs纯固体瘤).
主要成果:
- 放射性发现是LNMs的唯一显著因素.
- 部分固体瘤显示LNM的发病率较低 (1.5%),而非相邻的间叶膜/中叶膜LND的影响很小.
- 纯固体瘤的LNM率较高 (10.5%),有些转移到非相邻的结节,在S6瘤中选择性LND的复发率更高.
结论:
- 非相邻的间叶膜和中叶膜LND对部分固体瘤的节点分期的影响很小.
- 在纯固体瘤中建议选择性LND,以优化治疗并最大限度地降低复发风险.
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