Lymph node dissection as a local control during segmentectomy for small-sized and radiologically solid dominant and pure solid tumors.

BACKGROUND

Small-sized, peripherally located, and radiologically solid-dominant or pure solid nonsmall cell lung cancer (NSCLC) tumors are related to lymph node metastasis at a certain frequency. The aim of this study is to disclose the validity of lymph node dissection on oncological local control during segmentectomy for such tumors.

METHODS

We investigated the clinicopathological findings, the distribution of the involved lymph nodes, the patterns of lymph node recurrences, and the prognosis of 1921 patients with radiologically-determined ≤3 cm-sized, solid-dominant or pure solid NSCLC tumors without clinical lymph node involvement following complete resections with lobectomy (n = 1472) or segmentectomy (n = 449) between 2010 and 2020. The median follow-up duration for anonymized cases was 51.8 months.

RESULTS

The median age, solid tumor size, whole tumor size, and maximum of standardized uptake value were 72/69 years, 1.5/1.8 cm, 1.6/2.1 cm, and 2.0/3.5 in patients undergoing segmentectomy/lobectomy, respectively. Hilar lymph node metastases were recognized in 13 (3%) patients who underwent segmentectomy, and in 110 (8%) patients who underwent lobectomy, respectively. No patients experienced a recurrence of hilar lymph node metastasis in either adjacent or nonadjacent areas without distant metastasis after segmentectomy, while three patients experienced recurrence after lobectomy.

CONCLUSIONS

Lymph node dissection can be adequately performed during segmentectomy for selected small and peripherally located NSCLC tumors.