Abstract 493P
Background
Mediastinal lymph node dissection (MLND) is a crucial procedure during non-small cell lung cancer (NSCLC) resection, but the prognostic value of 4L lymph node dissection ( 4L-LND) continues to be controversial. Here, we conducted this systematic review and meta-analysis to evaluate the associations of 4L-LND with short- and long- term survival outcomes in surgically treated NSCLC patients.
Methods
We systematically searched studies from PubMed, Embase, and the Corchrane Library up to May 1, 2023. Studies investigating the prognostic value of 4L-LND and non-4L-LND on NSCLC survival were included. Data for analysis mainly included postoperative complications, overall survival (OS) and disease-free survival (DFS). We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of the included studies. The Q-test and I2-test were used to assess heterogeneity. The stability of pooled HRs was examined by sensitivity analysis.
Results
ix retrospective studies with a total of 4565 NSCLC patients who received 4L-LND or did not receive 4L-LND were included. The 4L-LND group had a significantly better OS (HR = 0.75, 95% CI: 0.61–0.91, P = 0.004) and DFS (HR = 0.76, 95% CI: 0.66–0.88, P = 0.0002) than the non-4L-LND group, especially in the subgroup analysis of PSM studies. Although no significant difference in chest tube drainage for more than 7 days rate (RR = 0.98, 95% CI: 0.31–3.08, P = 0.97), hoarseness rate (RR = 1.60, 95% CI: 0.53–4.87, P = 0.51), and chylothorax rate (RR = 1.28, 95% CI: 0.58–2.84, P = 0.54) was observed, however, those who received 4L-LND had a higher total postoperative complication rate than those who did not (RR = 1.35, 95% CI: 1.09–1.67, P = 0.006). There was no significant heterogeneity during our analysis, and no potential publication bias was observed among these studies.
Conclusions
Our meta-analysis showed that the 4L-LND group was significantly associated with both survival outcomes and postoperative complications compared to the non-4L-LND group in treating NSCLC patients. However, more prospective clinical trials should be well-designed to evaluate our conclusion due to the lack of guideline surpport.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
W. Li.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
519P - Final results and subgroup analysis of ORIENTAL: A phase IIIB study of durvalumab plus platinum-etoposide in first-line treatment of Chinese patients with extensive-stage small-cell lung cancer (ES-SCLC)
Presenter: Ying Cheng
Session: Poster Display
Resources:
Abstract
520P - Role of atezolizumab in controlling CNS progression in ES-SCLC
Presenter: Yoon Namgung
Session: Poster Display
Resources:
Abstract
521P - Camrelizumab combined with chemotherapy and apatinib as first-line therapy for extensive-stage small cell lung cancer: A phase II, single-arm, exploratory research
Presenter: Yanbin Zhao
Session: Poster Display
Resources:
Abstract
522P - Durvalumab plus etoposide and carboplatin for extensive-stage small cell lung cancer with mild idiopathic interstitial pneumonia
Presenter: Ichiro Nakachi
Session: Poster Display
Resources:
Abstract
523P - Camrelizumab plus apatinib as maintenance treatment in patients with extensive-stage small cell lung cancer who were responding or stable after standard first-line chemotherapy (CAMERA): Results from a single-arm, phase II trial
Presenter: Qi Wang
Session: Poster Display
Resources:
Abstract
524P - Treatment pattern and overall survival by lines of therapy among patients with advanced small cell lung cancer in Taiwan
Presenter: Kelly Huang
Session: Poster Display
Resources:
Abstract
525P - Development of diagnostic prediction score for malignant pleural effusion in lung cancer: MPE-Lung score
Presenter: Chaichana Chantharakhit
Session: Poster Display
Resources:
Abstract
526P - Burden and trends of tracheal, bronchus, and lung (TBL) cancer in Southeast Asia, East Asia, and Oceania from 1990-2019, and its projection of deaths to 2040: A benchmarking analysis
Presenter: Monika Chhayani
Session: Poster Display
Resources:
Abstract
527P - Efficacy of intraventricular chemotherapy with pemetrexed for leptomeningeal metastasis from lung adenocarcinoma: A retrospective study
Presenter: Fang Cun
Session: Poster Display
Resources:
Abstract
528P - Socioeconomic determinants of access to standard-of-care treatments in advanced and metastatic NSCLC in Hong Kong: A territory-wide study
Presenter: Ka Man Cheung
Session: Poster Display
Resources:
Abstract