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
561P - Mechanisms of osimertinib resistance using circulating tumor DNA analyses for EGFR-mutated non-small cell lung cancer, results from ELUCIDATOR: A prospective observational multicenter study
Presenter: Daijiro Harada
Session: Poster Display
Resources:
Abstract
562P - First-line (1L) osimertinib (osi) ± platinum-pemetrexed in patients (pts) with EGFRm advanced NSCLC: FLAURA2 China cohort
Presenter: Yan Yu
Session: Poster Display
Resources:
Abstract
563P - Real-world effectiveness and safety of first-line osimertinib for EGFR-mutated advanced NSCLC in China (FLOURISH study)
Presenter: Jianya Zhou
Session: Poster Display
Resources:
Abstract
564P - Co-occurring EGFR p.E709X mutation affects the treatment response to the third-generation EGFR-TKIs in EGFR p.G719X-mutant patients with advanced NSCLC
Presenter: Wen Feng Fang
Session: Poster Display
Resources:
Abstract
565P - Genome-guided targeted therapy combination improves survival in patients with advanced EGFR mutation positive NSCLC failing osimertinib
Presenter: Molly Li
Session: Poster Display
Resources:
Abstract
566P - Safety of tepotinib + osimertinib in EGFR-mutant NSCLC with MET amplification after first-line osimertinib
Presenter: Chong Kin Liam
Session: Poster Display
Resources:
Abstract
567P - Furmonertinib in combination with bevacizumab and intrathecal chemotherapy as later-line re-challenge treatment in EGFR –mutated NSCLC patients with leptomeningeal metastasis after third-generation EGFR-TKIs treatment failure
Presenter: Fang Cun
Session: Poster Display
Resources:
Abstract
568P - First-line (1L) osimertinib + platinum-pemetrexed in EGFR-mutated (EGFRm) advanced NSCLC: Updated FLAURA2 safety run-in (SRI) results
Presenter: David Planchard
Session: Poster Display
Resources:
Abstract
569P - Whole-transcriptome sequencing of transformed small-cell lung cancer from EGFR-mutated lung adenocarcinoma reveals LUAD–like and SCLC–like subsets
Presenter: Chan-Yuan Zhang
Session: Poster Display
Resources:
Abstract
570P - First-line osimertinib for patients with advanced NSCLC harboring EGFR mutations: A real-world study
Presenter: Wenxiang Ji
Session: Poster Display
Resources:
Abstract