Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial.
Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial.
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DOI：
10.1016/j.jtcvs.2010.11.008
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发表时间：
2011-03
影响因子：
6
通讯作者：
Putnam, Joe B., Jr.
中科院分区：
文献类型：
--
作者：
Darling, Gail E.;Allen, Mark S.;Decker, Paul A.;Ballman, Karla;Malthaner, Richard A.;Inculet, Richard I.;Jones, David R.;McKenna, Robert J.;Landreneau, Rodney J.;Rusch, Valerie W.;Putnam, Joe B., Jr.
确定与纵隔淋巴结采样（MLNS）相比，纵隔淋巴结清扫（MLND）是否能改善因N 0或非肺门N1、T1或T2非小细胞肺癌（NSCLC）而接受切除术的患者的生存率。对NSCLC患者的右侧肿瘤进行2 R、4 R、7和10 R采样，对左侧肿瘤进行5、6、7和10 L采样。如果所有患者均为恶性肿瘤阴性，则将患者随机分配至无进一步淋巴结采样（MLNS）或完全MLND。在1，111例随机化患者中，1，023例（498例MLNS，525例MLND）合格/可评价。两组之间在人口统计学、ECOG状态、组织学、癌症位置、切除类型或程度或病理分期方面无显著差异。MLND组中21例患者发现隐匿性N2病。在中位随访6.5年时，435例（43%）患者死亡;（MLNS：217例（44%）;MLND：218例（42%））。MLNS的中位生存期为8.1年，MLND为8.5年（p=0.25）。MLNS组的5年无病生存率为69%（95% CI：64%-74%），MLND组为68%（95% CI：64%-73%）（p=0.92）。两组之间的局部（p=0.52）、区域（p=0.10）或远处（p=0.76）复发无差异。如果纵隔和肺门淋巴结的系统性、彻底的预切取样为阴性，MLND不能提高早期NSCLC患者的生存率，但这些结果不能推广到放射学分期或更高分期肿瘤的患者。
To determine if mediastinal lymph node dissection (MLND) improves survival compared to mediastinal lymph node sampling (MLNS) in patients undergoing resection for N0 or non-hilar N1, T1 or T2 non-small cell lung cancer (NSCLC). Patients with NSCLC underwent sampling of 2R, 4R, 7 and 10R for right sided tumors, and 5, 6, 7 and 10L for left sided tumors. If all were negative for malignancy, patients were randomized to no further lymph node sampling (MLNS) or complete MLND. Of 1,111 patients randomized, 1,023 (498 MLNS, 525 MLND) were eligible/evaluable. There were no significant differences between the two groups in terms of demographics, ECOG status, histology, location of the cancer, type or extent of resection, or pathological stage. Occult N2 disease was found in 21 patients in the MLND group. At median follow-up of 6.5 years, 435 (43%) patients have died; (MLNS: 217 (44%);MLND:218 (42%)). The median survival for MLNS is8.1 years, and 8.5 years for MLND (p=0.25). The 5-year disease free survival rate was 69% (95% CI: 64%-74%) in the MLNS group versus 68%(95% CI: 64%-73%) years in the MLND group (p=0.92). There was no difference for local (p=0.52), regional (p=0.10), or distant (p=0.76) recurrence between the two groups. If systematic, thorough presection sampling of the mediastinal and hilar lymph nodes is negative, MLND does not improve survival in patients with early stage NSCLC but these results are not generalizable to patients staged radiographically or those with higher stage tumors.
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影响因子：
3.4
作者：
Doddoli, C;Aragon, A;Thomas, P
通讯作者：
Thomas, P
影响因子：
9
作者：
Izbicki, JR;Passlick, B;Thetter, O
通讯作者：
Thetter, O
影响因子：
10
作者：
Wright, G.;Manser, R. L.;Campbell, D. A.
通讯作者：
Campbell, D. A.
影响因子：
4.6
作者：
Little, AG;Rusch, VW;Stewart, AK
通讯作者：
Stewart, AK
影响因子：
4.6
作者：
Allen, MS;Darling, GE;Rusch, VW
通讯作者：
Rusch, VW