{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:47:22Z","timestamp":1791942442570,"version":"4.3.4"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"28","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Systematic mediastinal lymph node dissection (LND) or sampling is currently recommended for patients with early-stage non\u2013small cell lung cancer. We aimed to investigate whether no mediastinal LND was noninferior to systematic LND in patients with ground glass opacity (GGO)\u2013dominant invasive lung adenocarcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We conducted a multicenter, open-label, phase III, noninferiority randomized controlled trial comparing systematic mediastinal LND versus no mediastinal LND in patients with GGO-dominant invasive lung adenocarcinoma, who were predicted to have no lymph node metastasis on the basis of criteria established in our previous trial. The primary end point was 3-year disease-free survival. An interim analysis was planned upon enrollment of 300 patients, with predefined termination criteria if no mediastinal lymph node metastasis is detected and life-threatening complications occur in the systematic LND arm. This trial is registered on ClinicalTrials.gov (ECTOP-1009, identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT04527419\">NCT04527419<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Interim analysis of 302 patients revealed no lymph node metastasis in either study arm. The no LND arm had significantly reduced surgery duration (mean, 74 minutes\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      109 minutes;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), blood loss (mean, 44 mL\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      82 mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .033), and postoperative hospital stay (mean, 3.9 days\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      4.5 days;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002). Complications observed in the systematic LND arm included chylothorax in one patient (0.7%) and intraoperative massive bleeding because of superior vena cava injury in one patient (0.7%). No lymphadenectomy-related complications occurred in the no LND arm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>On the basis of interim findings and the principle of nonmaleficence, the trial should be terminated. Systematic mediastinal LND should no longer be recommended for patients with GGO-dominant lung adenocarcinoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-25-00610","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T19:59:32Z","timestamp":1753127972000},"page":"3081-3089","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":35,"title":["Phase III Study of Mediastinal Lymph Node Dissection for Ground Glass Opacity\u2013Dominant Lung Adenocarcinoma"],"prefix":"10.1200","volume":"43","clinical-trial-number":[{"clinical-trial-number":"nct04527419","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Yang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery and State Key Laboratory of Genetics and Development of Complex Phenotypes, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China"},{"name":"Institute of 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