{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:21:13Z","timestamp":1784013673684,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Asan Medical Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To investigate lymph node (LN) metastasis according to tumour location and assess the impact of lobe-specific LN dissection on survival in stage IA non-small-cell lung cancer (NSCLC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We retrospectively analysed the data of patients with clinical stage IA NSCLC treated with lobectomy and systematic LN dissection at Asan Medical Center (Seoul, Korea) between June 2005 and April 2017. Patients who received neoadjuvant therapy had multiple primary tumours or missed the follow-up during the first postoperative year were excluded. The patients were divided into five groups according to involved lung lobes: right upper lobe (RUL), right middle lobe (RML), right lower lobe (RLL), left upper lobe (LUL) and left lower lobe (LLL), which were further divided into subgroups according to LN station metastasis. Overall survival (OS) and the incidence of metastasis were calculated for each subgroup. Efficacy indices (EIs) were calculated to determine the correlation between each lung lobe and LN station, and the impact of the dissection of these stations on survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 1202 patients were analysed. The 5-year OS in the RUL, RML, RLL, LUL and LLL groups was 74%, 88%, 78%, 80% and 75%, respectively. The incidence of single LN station metastasis was 11%, 10%, 10%, 16% and 14%, respectively. The lobe-specific LNs for RUL, RML, RLL, LUL and LLL were stations 2\/3\/4, 4\/7, 2\/4\/7, 4\/5\/6 and 6\/7\/9, respectively. Moreover, the LN stations with high EIs for RUL, RML, RLL, LUL and LLL were 4, 7, 7, 5 and 7, respectively. In the RUL group, the incidence of metastasis to stations 2, 3 and 4 was 2.3%, 0.5% and 7.6%, and the EI was 0.8, 0.3 and 4.3, respectively. In RML, the incidence of metastasis to stations 4 and 7 was 4% and 6%, and the EI was 1.3 and 2.4, respectively. In RLL, the incidence of metastasis to stations 2, 4 and 7 was 4.4%, 5.6% and 8.3%, and the EI was 1.3, 1.4 and 3.3, respectively. In LUL, the incidence of metastasis to stations 4, 5 and 6 was 1.4%, 11.8% and 2.5%, and the EI was 0.4, 7.1 and 0.5, respectively. In LLL, the incidence of metastasis to stations 6, 7 and 9 was 1.1%, 5.7% and 1.7%, and the EI was 0.6, 2.3 and 0.5, respectively. Furthermore, the OS of patients with lobe-specific LN metastasis was statistically significantly different from that of the non-lobe-specific LN metastasis group with P-values of &amp;lt;0.001 for RUL, 0.002 for RML, 0.002 for RLL, 0.001 for LUL and 0.003 for LLL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our findings support the use of lobe-specific LN dissection in stage IA NSCLC. When LN stations with high EI were negative, LN metastasis in other stations was unlikely. The incidence of LN metastasis beyond lobe-specific LN stations was \u223c1% in all subgroups. Dissection of non-lobe-specific LNs may not improve the OS; however, prospective randomized controlled trials are needed to modify the standard approach.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa369","type":"journal-article","created":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T11:10:37Z","timestamp":1599822637000},"page":"783-790","source":"Crossref","is-referenced-by-count":21,"title":["Lobe-specific lymph node dissection in stage IA non-small-cell lung cancer: a retrospective cohort study"],"prefix":"10.1093","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3289-841X","authenticated-orcid":false,"given":"Tariq Ziad","family":"Abughararah","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"},{"name":"Department of Thoracic Surgery, Prince Mohammed Bin Abdulaziz Hospital, MNGHA, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Ho","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahd","family":"Alabbood","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yooyoung","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5364-5548","authenticated-orcid":false,"given":"Jae Kwang","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1890-7455","authenticated-orcid":false,"given":"Geun Dong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Ryul","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2177-4876","authenticated-orcid":false,"given":"Yong-Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1984-0352","authenticated-orcid":false,"given":"Dong Kwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8729-0498","authenticated-orcid":false,"given":"Seung-Il","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"2021042915250845400_ezaa369-B1","doi-asserted-by":"crossref","first-page":"e278S","DOI":"10.1378\/chest.12-2359","article-title":"Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"143","author":"Howington","year":"2013","journal-title":"Chest"},{"key":"2021042915250845400_ezaa369-B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejcts.2007.01.075","article-title":"ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer","volume":"32","author":"De Leyn","year":"2007","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021042915250845400_ezaa369-B3","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1093\/ejcts\/ezu028","article-title":"Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer","volume":"45","author":"De Leyn","year":"2014","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021042915250845400_ezaa369-B4","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/00000658-199801000-00020","article-title":"Effectiveness of radical systematic mediastinal lymphadenectomy in patients with resectable non-small cell lung cancer results of a prospective randomized trial","volume":"227","author":"Izbicki","year":"1998","journal-title":"Ann Surg"},{"key":"2021042915250845400_ezaa369-B5","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/S0003-4975(00)01673-8","article-title":"Mediastinal lymph node dissection improves survival in patients with stages II and IIIa non-small cell lung cancer","volume":"70","author":"Keller","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"2021042915250845400_ezaa369-B6","doi-asserted-by":"crossref","first-page":"2728","DOI":"10.21037\/jtd.2017.07.77","article-title":"Mediastinal lymph node dissection in surgical treatment for early stage non-small-cell lung cancer: lobe-specific or systematic?","volume":"9","author":"Adachi","year":"2017","journal-title":"J Thorac Dis"},{"key":"2021042915250845400_ezaa369-B7","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jtho.2016.08.127","article-title":"Lobe-specific lymph node dissection as a standard procedure in surgery for non-small cell lung cancer: a propensity score matching study","volume":"12","author":"Adachi","year":"2017","journal-title":"J Thorac Oncol"},{"key":"2021042915250845400_ezaa369-B8","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.ejcts.2006.08.008","article-title":"ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer","volume":"30","author":"Lardinois","year":"2006","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021042915250845400_ezaa369-B9","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1055\/s-2006-924626","article-title":"Is lobe-specific lymph node dissection appropriate in lung cancer patients undergoing routine mediastinoscopy?","volume":"55","author":"Turna","year":"2007","journal-title":"Thorac Cardiovasc Surg"},{"key":"2021042915250845400_ezaa369-B10","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1097\/JTO.0000000000000546","article-title":"Mediastinal nodal involvement in patients with clinical stage I non-small-cell lung cancer: possibility of rational lymph node dissection","volume":"10","author":"Haruki","year":"2015","journal-title":"J Thorac Oncol"},{"key":"2021042915250845400_ezaa369-B11","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.jtcvs.2009.07.024","article-title":"Effect of selective lymph node dissection based on patterns of lobe-specific lymph node metastases on patient outcome in patients with resectable non-small cell lung cancer: a large-scale retrospective cohort study applying a propensity score","volume":"139","author":"Ishiguro","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021042915250845400_ezaa369-B12","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1007\/s00595-013-0772-5","article-title":"Validity of using lobe-specific regional lymph node stations to assist navigation during lymph node dissection in early stage non-small cell lung cancer patients","volume":"44","author":"Miyoshi","year":"2014","journal-title":"Surg Today"},{"key":"2021042915250845400_ezaa369-B13","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.chest.2016.10.010","article-title":"The eighth edition lung cancer stage classification","volume":"151","author":"Detterbeck","year":"2017","journal-title":"Chest"},{"key":"2021042915250845400_ezaa369-B14","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/bjs.1800820321","article-title":"New method to evaluate the therapeutic value of lymph node dissection for gastric cancer","volume":"82","author":"Sasako","year":"1995","journal-title":"Br J Surg"},{"key":"2021042915250845400_ezaa369-B15","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.athoracsur.2016.09.037","article-title":"The oncologic outcome of esophageal squamous cell carcinoma patients after robot-assisted thoracoscopic esophagectomy with total mediastinal lymphadenectomy","volume":"103","author":"Park","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2021042915250845400_ezaa369-B16","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1510\/icvts.2010.236349","article-title":"Prognostic classifications of lymph node involvement in lung cancer and current International Association for the Study of Lung Cancer descriptive classification in zones","volume":"11","author":"Riquet","year":"2010","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2021042915250845400_ezaa369-B17","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1097\/01.JTO.0000263722.22686.1c","article-title":"European trends in preoperative and intraoperative nodal staging: ESTS guidelines","volume":"2","author":"De Leyn","year":"2007","journal-title":"J Thorac Oncol"},{"key":"2021042915250845400_ezaa369-B18","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.21037\/jtd.2017.07.23","article-title":"Occult pN2 disease in lung cancer patients: a wide range of diseases endangering the long term prognosis","volume":"9","author":"Riquet","year":"2017","journal-title":"J Thorac Dis"},{"key":"2021042915250845400_ezaa369-B19","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1016\/j.jtho.2016.05.014","article-title":"Lobe-specific nodal dissection for clinical stage I and II NSCLC: Japanese Multi-Institutional retrospective study using a propensity score analysis","volume":"11","author":"Hishida","year":"2016","journal-title":"J Thorac Oncol"},{"key":"2021042915250845400_ezaa369-B20","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.21037\/jtd.2018.04.137","article-title":"Can lobe-specific lymph node dissection be an alternative to systematic lymph node dissection in treating early-stage non-small cell lung cancer: a comprehensive systematic review and meta-analysis?","volume":"10","author":"Deng","year":"2018","journal-title":"J Thorac Dis"},{"key":"2021042915250845400_ezaa369-B21","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.21037\/jtd.2017.06.04","article-title":"Selective lymph node dissection in early-stage non-small cell lung cancer","volume":"9","author":"Han","year":"2017","journal-title":"J Thorac Dis"},{"key":"2021042915250845400_ezaa369-B22","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1016\/j.athoracsur.2005.12.067","article-title":"Distribution and likelihood of lymph node metastasis based on the lobar location of nonsmall-cell lung cancer","volume":"81","author":"Cerfolio","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"2021042915250845400_ezaa369-B23","first-page":"101","article-title":"Comparison of lobe-specific mediastinal lymphadenectomy versus systematic mediastinal lymphadenectomy for clinical stage T 1a N 0 M 0 non-small cell lung cancer","volume":"9(Suppl 2","author":"Ma","year":"2013","journal-title":"J Cancer Res Ther"},{"key":"2021042915250845400_ezaa369-B24","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1378\/chest.12-3069","article-title":"Lobe-specific mediastinal nodal dissection is sufficient during lobectomy by video-assisted thoracic surgery or thoracotomy for early-stage lung cancer","volume":"144","author":"Shapiro","year":"2013","journal-title":"Chest"},{"key":"2021042915250845400_ezaa369-B25","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/ejcts\/ezu226","article-title":"Is the lymphatic drainage of lung cancer lobe-specific? A surgical appraisal","volume":"47","author":"Riquet","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021042915250845400_ezaa369-B26","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.lungcan.2003.10.012","article-title":"Involvement of lymphatic metastatic spread in non-small cell lung cancer accordingly to the primary cancer location","volume":"44","author":"Kotoulas","year":"2004","journal-title":"Lung Cancer"},{"key":"2021042915250845400_ezaa369-B27","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.athoracsur.2013.03.050","article-title":"Predictive factors for node metastasis in patients with clinical stage I non-small cell lung cancer","volume":"96","author":"Cho","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2021042915250845400_ezaa369-B28","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1111\/1759-7714.13121","article-title":"Assessment of non-lobe-specific lymph node metastasis in clinical stage IA non-small cell lung cancer","volume":"10","author":"Zhang","year":"2019","journal-title":"Thorac Cancer"},{"key":"2021042915250845400_ezaa369-B29","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1093\/jjco\/hyx170","article-title":"A randomized phase III trial of lobe-specific vs. systematic nodal dissection for clinical stage I-II non-small cell lung cancer (JCOG1413)","volume":"48","author":"Hishida","year":"2018","journal-title":"Jpn J Clin Oncol"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/59\/4\/783\/37582879\/ezaa369.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/59\/4\/783\/37582879\/ezaa369.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T15:26:09Z","timestamp":1619709969000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/59\/4\/783\/5956254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,5]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,11,5]]},"published-print":{"date-parts":[[2021,4,29]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezaa369","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4,1]]},"published":{"date-parts":[[2020,11,5]]}}}