Lobe-Specific Lymph Node Dissection in Clinical Stage IA Solid-Dominant Non-Small Cell Lung Cancer: A Propensity Score Matching Study

Abstract Background Lobectomy with systematic lymph node dissection (SND) remains the standard procedure for resectable NSCLC, while lobe-specific lymph node dissection (LSND) was reported to have more advantages in perioperative recovery and complication reduction in treating early-stage diseases. Survival outcomes after LSND remains controversial comparing to SND. Methods From 2014 to 2017, data of 546 patients with clinical stage IA solid-dominant NSCLC and underwent curative lobectomies with LSND (n=100) or SND (n=446) at our institution were collected. Propensity score matching (PSM) was conducted to eliminate the biases. 5-year disease-free survival (DFS) and overall survival (OS) were compared between the groups. Perioperative parameters and postoperative complications were also analyzed. Results Lobectomies with LSND or SND were performed in 100 patients and 446 patients, respectively. After matching, there were 100 patients in each group and no significant differences in 5- year OS (p=0.473) and DFS (p=0.789) were found between the groups. Recurrence patterns were also similar (p=0.733). Perioperative parameters were similar while the incidence of postoperative complications in SND group was found to be significantly higher than that in LSND group (p=0.003). Conclusions Our study demonstrated that LSND has similar efficiency to SND in terms of survival, recurrence, lymph node dissection and perioperative recovery of clinical stage IA solid-dominant NSCLC patients, besides, significant advantages in reducing postoperative complications. Therefore, curative lobectomies with LSND may be more suitable and practical for clinical stage IA solid-dominant NSCLC patients.