Lobe-Specific nodal dissection for clinical stage I and II NSCLC: Japanese Multi-Institutional retrospective study using a propensity score analysis

Tomoyuki Hishida, Etsuo Miyaoka, Kohei Yokoi, Masahiro Tsuboi, Hisao Asamura, Katsuyuki Kiura, Kazuhisa Takahashi, Hirotoshi Dosaka-Akita, Hideo Kobayashi, Hiroshi Date, Hirohito Tada, Meinoshin Okumura, Ichiro Yoshino

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to assess the surgical outcomes according to the extent of mediastinal lymph node dissection for patients with NSCLC by using a nationwide registry database. Methods: From among 11,663 patients in a Japanese lung cancer registry study for 2004, 5392 patients with clinical stage (c-stage) I or II NSCLC that was completely resected by lobectomy and either systematic (SND) or lobe-specific nodal dissection (LSD) were enrolled. Patients who received preoperative therapy or had middle lobe tumor were excluded. In the LSD group, inferior mediastinal (subcarinal) nodes were not dissected for upper lobe tumors, and superior mediastinal nodes were not dissected for lower lobe tumors. To reduce the selection bias, an inverse probability of treatment weighting method using a propensity score was implemented. Results: LSD and SND were performed in 1268 patients (23.5%) and 4124 patients (76.5%), respectively. The LSD group included more upper lobe and c-stage I tumors and less pathological N2 disease than the SND group. Extended pathological N2 disease outside LSD area was found in 3.2% of the SND group. The 5-year overall survival was 81.5% in the LSD group and 75.9% in the SND group. An inverse probability of treatment weighting-Adjusted Cox model showed that LSD did not have a negative prognostic impact and instead was associated with favorable survival (hazard ratio = 0.68, 95% confidence interval: 0.60=0.77). Conclusions: This retrospective registry study suggested that LSD is an alternative to SND for selected patients with c-stage I or II NSCLC. Future prospective studies are warranted to determine whether LSD is applicable and provides clinical benefit for the general population of patients with cstage I or II NSCLC.

Original languageEnglish
Pages (from-to)1529-1537
Number of pages9
JournalJournal of Thoracic Oncology
Volume11
Issue number9
DOIs
Publication statusPublished - 2016

Fingerprint

Propensity Score
Dissection
Retrospective Studies
Registries
Neoplasms
Survival
Selection Bias
Lymph Node Excision
Proportional Hazards Models
Lung Neoplasms
Therapeutics
Databases
Prospective Studies
Confidence Intervals

Keywords

  • Lobe-specific nodal dissection
  • Lobectomy
  • Lymph node dissection
  • NSCLC
  • Surgery
  • Systematic nodal dissection

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Lobe-Specific nodal dissection for clinical stage I and II NSCLC : Japanese Multi-Institutional retrospective study using a propensity score analysis. / Hishida, Tomoyuki; Miyaoka, Etsuo; Yokoi, Kohei; Tsuboi, Masahiro; Asamura, Hisao; Kiura, Katsuyuki; Takahashi, Kazuhisa; Dosaka-Akita, Hirotoshi; Kobayashi, Hideo; Date, Hiroshi; Tada, Hirohito; Okumura, Meinoshin; Yoshino, Ichiro.

In: Journal of Thoracic Oncology, Vol. 11, No. 9, 2016, p. 1529-1537.

Research output: Contribution to journalArticle

Hishida, T, Miyaoka, E, Yokoi, K, Tsuboi, M, Asamura, H, Kiura, K, Takahashi, K, Dosaka-Akita, H, Kobayashi, H, Date, H, Tada, H, Okumura, M & Yoshino, I 2016, 'Lobe-Specific nodal dissection for clinical stage I and II NSCLC: Japanese Multi-Institutional retrospective study using a propensity score analysis', Journal of Thoracic Oncology, vol. 11, no. 9, pp. 1529-1537. https://doi.org/10.1016/j.jtho.2016.05.014
Hishida, Tomoyuki ; Miyaoka, Etsuo ; Yokoi, Kohei ; Tsuboi, Masahiro ; Asamura, Hisao ; Kiura, Katsuyuki ; Takahashi, Kazuhisa ; Dosaka-Akita, Hirotoshi ; Kobayashi, Hideo ; Date, Hiroshi ; Tada, Hirohito ; Okumura, Meinoshin ; Yoshino, Ichiro. / Lobe-Specific nodal dissection for clinical stage I and II NSCLC : Japanese Multi-Institutional retrospective study using a propensity score analysis. In: Journal of Thoracic Oncology. 2016 ; Vol. 11, No. 9. pp. 1529-1537.
@article{b759d46e001545969f30ca2b50de0e1c,
title = "Lobe-Specific nodal dissection for clinical stage I and II NSCLC: Japanese Multi-Institutional retrospective study using a propensity score analysis",
abstract = "Objectives: The purpose of this study was to assess the surgical outcomes according to the extent of mediastinal lymph node dissection for patients with NSCLC by using a nationwide registry database. Methods: From among 11,663 patients in a Japanese lung cancer registry study for 2004, 5392 patients with clinical stage (c-stage) I or II NSCLC that was completely resected by lobectomy and either systematic (SND) or lobe-specific nodal dissection (LSD) were enrolled. Patients who received preoperative therapy or had middle lobe tumor were excluded. In the LSD group, inferior mediastinal (subcarinal) nodes were not dissected for upper lobe tumors, and superior mediastinal nodes were not dissected for lower lobe tumors. To reduce the selection bias, an inverse probability of treatment weighting method using a propensity score was implemented. Results: LSD and SND were performed in 1268 patients (23.5{\%}) and 4124 patients (76.5{\%}), respectively. The LSD group included more upper lobe and c-stage I tumors and less pathological N2 disease than the SND group. Extended pathological N2 disease outside LSD area was found in 3.2{\%} of the SND group. The 5-year overall survival was 81.5{\%} in the LSD group and 75.9{\%} in the SND group. An inverse probability of treatment weighting-Adjusted Cox model showed that LSD did not have a negative prognostic impact and instead was associated with favorable survival (hazard ratio = 0.68, 95{\%} confidence interval: 0.60=0.77). Conclusions: This retrospective registry study suggested that LSD is an alternative to SND for selected patients with c-stage I or II NSCLC. Future prospective studies are warranted to determine whether LSD is applicable and provides clinical benefit for the general population of patients with cstage I or II NSCLC.",
keywords = "Lobe-specific nodal dissection, Lobectomy, Lymph node dissection, NSCLC, Surgery, Systematic nodal dissection",
author = "Tomoyuki Hishida and Etsuo Miyaoka and Kohei Yokoi and Masahiro Tsuboi and Hisao Asamura and Katsuyuki Kiura and Kazuhisa Takahashi and Hirotoshi Dosaka-Akita and Hideo Kobayashi and Hiroshi Date and Hirohito Tada and Meinoshin Okumura and Ichiro Yoshino",
year = "2016",
doi = "10.1016/j.jtho.2016.05.014",
language = "English",
volume = "11",
pages = "1529--1537",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "International Association for the Study of Lung Cancer",
number = "9",

}

TY - JOUR

T1 - Lobe-Specific nodal dissection for clinical stage I and II NSCLC

T2 - Japanese Multi-Institutional retrospective study using a propensity score analysis

AU - Hishida, Tomoyuki

AU - Miyaoka, Etsuo

AU - Yokoi, Kohei

AU - Tsuboi, Masahiro

AU - Asamura, Hisao

AU - Kiura, Katsuyuki

AU - Takahashi, Kazuhisa

AU - Dosaka-Akita, Hirotoshi

AU - Kobayashi, Hideo

AU - Date, Hiroshi

AU - Tada, Hirohito

AU - Okumura, Meinoshin

AU - Yoshino, Ichiro

PY - 2016

Y1 - 2016

N2 - Objectives: The purpose of this study was to assess the surgical outcomes according to the extent of mediastinal lymph node dissection for patients with NSCLC by using a nationwide registry database. Methods: From among 11,663 patients in a Japanese lung cancer registry study for 2004, 5392 patients with clinical stage (c-stage) I or II NSCLC that was completely resected by lobectomy and either systematic (SND) or lobe-specific nodal dissection (LSD) were enrolled. Patients who received preoperative therapy or had middle lobe tumor were excluded. In the LSD group, inferior mediastinal (subcarinal) nodes were not dissected for upper lobe tumors, and superior mediastinal nodes were not dissected for lower lobe tumors. To reduce the selection bias, an inverse probability of treatment weighting method using a propensity score was implemented. Results: LSD and SND were performed in 1268 patients (23.5%) and 4124 patients (76.5%), respectively. The LSD group included more upper lobe and c-stage I tumors and less pathological N2 disease than the SND group. Extended pathological N2 disease outside LSD area was found in 3.2% of the SND group. The 5-year overall survival was 81.5% in the LSD group and 75.9% in the SND group. An inverse probability of treatment weighting-Adjusted Cox model showed that LSD did not have a negative prognostic impact and instead was associated with favorable survival (hazard ratio = 0.68, 95% confidence interval: 0.60=0.77). Conclusions: This retrospective registry study suggested that LSD is an alternative to SND for selected patients with c-stage I or II NSCLC. Future prospective studies are warranted to determine whether LSD is applicable and provides clinical benefit for the general population of patients with cstage I or II NSCLC.

AB - Objectives: The purpose of this study was to assess the surgical outcomes according to the extent of mediastinal lymph node dissection for patients with NSCLC by using a nationwide registry database. Methods: From among 11,663 patients in a Japanese lung cancer registry study for 2004, 5392 patients with clinical stage (c-stage) I or II NSCLC that was completely resected by lobectomy and either systematic (SND) or lobe-specific nodal dissection (LSD) were enrolled. Patients who received preoperative therapy or had middle lobe tumor were excluded. In the LSD group, inferior mediastinal (subcarinal) nodes were not dissected for upper lobe tumors, and superior mediastinal nodes were not dissected for lower lobe tumors. To reduce the selection bias, an inverse probability of treatment weighting method using a propensity score was implemented. Results: LSD and SND were performed in 1268 patients (23.5%) and 4124 patients (76.5%), respectively. The LSD group included more upper lobe and c-stage I tumors and less pathological N2 disease than the SND group. Extended pathological N2 disease outside LSD area was found in 3.2% of the SND group. The 5-year overall survival was 81.5% in the LSD group and 75.9% in the SND group. An inverse probability of treatment weighting-Adjusted Cox model showed that LSD did not have a negative prognostic impact and instead was associated with favorable survival (hazard ratio = 0.68, 95% confidence interval: 0.60=0.77). Conclusions: This retrospective registry study suggested that LSD is an alternative to SND for selected patients with c-stage I or II NSCLC. Future prospective studies are warranted to determine whether LSD is applicable and provides clinical benefit for the general population of patients with cstage I or II NSCLC.

KW - Lobe-specific nodal dissection

KW - Lobectomy

KW - Lymph node dissection

KW - NSCLC

KW - Surgery

KW - Systematic nodal dissection

UR - http://www.scopus.com/inward/record.url?scp=84987848044&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84987848044&partnerID=8YFLogxK

U2 - 10.1016/j.jtho.2016.05.014

DO - 10.1016/j.jtho.2016.05.014

M3 - Article

C2 - 27249959

AN - SCOPUS:84987848044

VL - 11

SP - 1529

EP - 1537

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

IS - 9

ER -