Long-Term Oncological Outcomes Related to Lymphadenectomy in Clinical Stage I NSCLC: A Multicenter Retrospective Experience

Background: Lymphadenectomy is considered a key part of the radical treatment of resectable lung cancer, although its appropriate extension in early stages is a debated topic due to the great heterogeneity of studies in the literature. This study aims to evaluate the impact of lymphadenectomy extent on survival and recurrence in the treatment of early-stage NSCLC patients undergoing lobectomy and lymph node dissection. Methods: Data from clinical stage I NSCLC patients undergoing lobectomy and hilar-mediastinal lymphadenectomy at two thoracic surgery centers from 2016 to 2019 were retrospectively evaluated. Information regarding perioperative outcomes and lymphadenectomy details was collected and analyzed, and their impact on OS, CSS, and DFS was assessed. Results: During the period under review, 323 patients with stage cI lung cancer underwent lobectomy with lymphadenectomy. Statistical analysis showed that the evaluated lymph nodal factors (mean number of lymph nodes removed and number and type of lymph node station explored) did not statistically significantly impact OS, CSS, and DFS at a median follow-up of 59 months (IQR 45–71). Conclusions: The results of this study suggest that a less invasive procedure than systematic lymphadenectomy could be performed in early-stage cases with adequate preoperative staging.