A.F. GILMETDINOV¹, V.P. POTANIN^2,3

¹Emergency Hospital, 18 Naberezhnochelninsky Pr., Naberezhnye Chelny, Russian Federation, 423803

²Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, 36 Butlerov Str., Kazan, Russian Federation, 420012

³Tatarstan Cancer Center, 29 Sibirskiy Trakt, Kazan, Russian Federation, 420029

 Gilmetdinov A.F. ― oncologist of the Oncology Department, tel. (8552) 30-49-10, e-mail: bozkurt@mail.ru

Potanin V.P. ― D. Med. Sc., Professor of the Department of Oncology, Radiology and Palliative Medicine, Head of Thoracic Department, tel. (843) 519-26-00, e-mail: rkod.mzrt@tatar.ru

The lesion of regional lymph nodes is one of the most important prognostic factors in non-small cell lung cancer. The increasing the number of involved lymph nodes, groups of nodes, the increasing level of destruction is inversely proportional to survival. The relatively new concept is «lymph node ratio» (LNR), meaning the ratio of involved lymph nodes to the total number of the investigated nodes. Survival analysis in a number of studies found an inverse proportional relationship between the rate of lymph node involvement and survival. The article presents the results of a retrospective analysis of survival of patients with non-small cell lung cancer, depending on the performance of an ipsilateral lobar lymph node dissection. The influence of the lymph node ratio (LNR) on the need to ipsilateral lobar lymph node dissection was investigated. The results exclude the impact of the lymph node ratio on survival, depending on the performance of an ipsilateral lobar lymph node dissection. Thus, the ipsilateral lobar lymph node dissection should be performed in the surgical treatment of non-small cell lung cancer, regardless of the lymph node ratio.

Key words: non-small-cell lung cancer, ipsilateral lobar lymph node dissection, lymph node ratio.

REFERENCES

1. Keller S.M., Vangel M.G., Wagner H. et al. Prolonged survival in patients with resected non-small cell lung cancer and single-level N2 disease. The journal of thoracic and cardio-vascular surgery, 2004, pp. 130-137.
2. Ohta Y., Shimizu Y., Minato H. et al. Results of initial operations in non-small cell lung cancer patients with single-level N2 disease. Annals of thoracic surgery, 2006, pp. 427-433.
3. Watanabe Sh., Asamura H. Lymph node dissection for lung cancer: significance, strategy and technique. Journal of thoracic oncology, 2009, no. 4, pp. 652-657.
4. Inoue M., Sawabata N., Takeda S. et al. Results of surgical intervention for p-stage IIIA (N2) non-small cell lung cancer: acceptable prognosis predicted by complete resection in patients with single N2 disease with primary tumor in the upper lobe. The journal of thoracic and cardio-vascular surgery, 2004, pp. 1100-1106.
5. Lardinois D., De Leyn P., Van Schil P. et al. ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer. European journal of cardio-thoracic surgery, 2006, pp. 787-792.
6. Mezhdunarodnyy Protivorakovyy Soyuz. TNM. Klassifikatsiya zlokachestvennykh opukholey. Shestoe izdanie, perevod i red. prof. N.N. Blinova [International Anticancer Union. TNM. Classification of malignant tumors. The sixth edition, translation and ed. prof. N.N. Blinov]. Saint Petersburg: OOO “Eskulap”, 2003. 243 p.
7. Lee J.G., Lee C.Y., Park I.K. et al. The prognostic significance of multiple station N2 in patients with surgically resected stage IIIA N2 non-small cell lung cancer. Journal of Korean medical science, 2008, pp. 604-608.
8. Qiu C., Dong W., Su B., Liu Q., Du J. et al. The prognostic value of ratio-based lymph node staging in resected non-small-cell lung cancer. Journal of thoracic oncology, 2013, no. 4, pp. 429-435.