The influence of the ipsilateral bronchopulmonary lymph node dissection on survival rate in non-small-cell lung cancer

Aim. The analysis of the survival rates depending on the extent of surgery and the influence of ipsilateral bronchopulmonary lymph node dissection on this indicator.

Methods. Medical charts of 1324 in- and outpatients who underwent surgeries in the department of thoracic surgery №1 in 2000-2009 were analyzed. Patients were allocated to the groups (944 patients in total) according to clinical form and stage (peripheral cancer - 555 patients, central cancer - 389 patients), histological type (peripheral cancer - 254 patients with adenocarcinoma and 204 patients with squamous cell carcinoma, central cancer - 44 patients with adenocarcinoma and 304 patients with squamous cell carcinoma). 5-year survival rate was calculated in each group depending on the extent of surgery (lobectomy, pneumonectomy), and the impact of ipsilateral bronchopulmonary lymph node dissection that was performed in all cases of pulmonectomy on this indicator was analyzed.

Results. After lobectomy, 5-year survival rates were similar in both groups - 57.08 and 55.14% (p=0.8). However, 5-year survival rate in patients after pneumonectomy due to central lung cancer (41.13%) was significantly higher compared to peripheral cancer (26.83%, p=0.02). Survival rates for the certain stages of the disease after pneumonectomy due to central cancer were significantly higher when compared to peripheral cancer. No significant differences in survival rates in different histological types of peripheral cancer and in the central form of lung adenocarcinoma were revealed, in contrast to squamous cell cancer. The survival rates after pulmonectomy in cases of central squamous cancer were only slightly different from those after lobectomy. Gained preliminary data of retrospective analysis reflect the influence of lymph node dissection on survival.

Conclusion. The best results after pneumonectomy were obtained in patients with central form of squamous cell carcinoma. However, in the cases of peripheral cancer early stages of the disease prevailed after lobectomy, which obviously increased survival rates. If proven, the proposed method will enhance the survival rates in patients with non-small cell lung cancer.