SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1583508
Dissection of 4L lymph node for left-sided non-small cell lung cancer: a metaanalysis
Provisionally accepted
- Second Affiliated Hospital of Nanchang University, Nanchang, China
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Background: The therapeutic efficacy of left lower paratracheal (4L) lymph node dissection in the management of left-sided non-small cell lung cancer (NSCLC) remains an unresolved clinical question. Thus, we performed a meta-analysis to compare the survival of the left-sided NSCLC patients treating with 4L lymph node dissection (LND+) and those without (LND-).Methods: Seven databases were searched for relevant studies comparing left-sided NSCLC patients with 4L lymph node dissection and those without. The primary endpoints were survival indicators, including overall survival (OS) and disease-free survival (DFS). Secondary endpoints included hospitalization and follow-up outcomes.Results: After thorough screening of 431 studies, six studies encompassing 4253 patients were selected for the final analysis. The LND+ group had a better OS (Hazard ratio [HR]: 0.65 [0.52, 0.81], p<0.0001) and DFS (HR: 0.82 [0.71, 0.95], p=0.008). The survival rates of OS at 1-5 years and DFS at 1 year were also higher in the 4L LND+ group. The two group were similar in the comparison of postoperative complications and recurrence. Conclusions: Through above results, 4L lymph node dissection should be performed for left-sided resectable NSCLC, due to its association with improved OS and DFS.
Keywords: Dissection, left, 4L lymph node, Non-Small Lung Cancer, Meta-analysis
Received: 26 Feb 2025; Accepted: 20 May 2025.
Copyright: © 2025 Chenxi, Hu, Wu, Zhou, Zhang and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chao Song, Second Affiliated Hospital of Nanchang University, Nanchang, China
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