Frontiers in Oncology (Apr 2023)

Clinicopathological and survival outcomes of 4L lymph node dissection in left lung adenocarcinoma and squamous cell carcinoma

  • Leilei Shen,
  • Leilei Shen,
  • Leilei Shen,
  • Juntang Guo,
  • Juntang Guo,
  • Juntang Guo,
  • Weidong Zhang,
  • Weidong Zhang,
  • Weidong Zhang,
  • Chaoyang Liang,
  • Chaoyang Liang,
  • Chaoyang Liang,
  • Han Chen,
  • Yang Liu,
  • Yang Liu,
  • Yang Liu

DOI
https://doi.org/10.3389/fonc.2023.1124014
Journal volume & issue
Vol. 13

Abstract

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BackgroundWhether 4L lymph node dissection (LND) should be performed remains unclear and controversial. Prior studies have found that station 4L metastasis was not rare and that 4L LND may provide survival benefits. The objective of this study was to analyze the clinicopathological and survival outcomes of 4L LND from the perspective of histology.MethodsThis retrospective study included 74 patients with squamous cell carcinoma (SCC) and 84 patients diagnosed with lung adenocarcinoma (ADC) between January 2008 and October 2020. All patients underwent pulmonary resection with station 4L LND and were staged as T1-4N0-2M0. Clinicopathological features and survival outcomes were investigated based on histology. The study endpoints were disease-free survival (DFS) and overall survival (OS).ResultsThe incidence rate of station 4L metastasis was 17.1% (27/158) in the entire cohort, with 8.1% in the SCC group, and 25.0% in the ADC group. No statistical differences in the 5-year DFS rates (67.1% vs. 61.7%, P=0.812) and 5-year OS rates (68.6% vs. 59.3%, P=0.100) were observed between the ADC group and the SCC group. Multivariate logistic analysis revealed that histology (SCC vs. ADC: OR, 0.185; 95% CI, 0.049–0.706; P=0.013) was independently associated with 4L metastasis. Multivariate survival analysis showed that the status of 4L metastasis was an independent factor for DFS (HR, 2.563; 95% CI, 1.282–5.123; P=0.008) but not for OS (HR, 1.597; 95% CI, 0.749–3.402; P=0.225).ConclusionStation 4L metastasis is not rare in left lung cancer. Patients with ADC have a greater predilection for station 4L metastasis and may benefit more from performing 4L LND.

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