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SLND and Contralateral Mediastinal Lymphadenectomy for Non–Small Cell Lung Cancer

By: Andrew Goldstein
Posted: Wednesday, November 29, 2017

Treating patients with non–small cell lung cancer (NSCLC) located in the left lower lobe with both systematic lymph node dissection (SLND) and contralateral mediastinal lymphadenectomy correlated with significantly higher 4-year survival rates, according to an abstract (OA 04.01) presented at the 2017 International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer. However, no significant difference in survival rates were found for tumors located in the right lung or the left upper lobe. Jaroslaw Kuzdzal, MD, FETCS, of the Department of Thoracic Surgery, John Paul II Hospital, Krakow, Poland, and colleagues noted that larger studies are necessary to confirm their findings.

The researchers randomly assigned 89 patients with proven or suspected NSCLC stage cI–IIIA to an SLND group. A total of 49 patients received standard lung resection with SLND (SLND group); the other 40 patients received SLND with contralateral mediastinal lymphadenectomy (the bilateral mediastinal lymphadenectomy [BML] group).

Overall, the BML group displayed a 4-year survival rate of 72.5% compared with 51% for the SLND group. No significant difference in survival rates were found for tumors located in the right lung or the left upper lobe. For tumors found in the left lower lobe, the 4-year survival rate in the BML group was 90.9% versus 25% for the SLND group, and the mean survival time was higher in the BML group (1923 days vs. 1244 days).