A randomized trial of systematic nodal dissection in resectable XXXX .

@entity1 @entity5 @entity1149 @entity1764 @entity3
PURPOSE: We conducted a randomized trial to investigate whether systematic nodal dissection (SND) is superior to @entity1764 ( @entity1764 ) in surgical treatment of @entity1149 ( @entity1149 ). METHODS: The @entity1 resectable clinical Stage I-IIIA @entity1149 were randomly assigned to lung resection combined with SND or lung resection combined with @entity1764 . After postoperative pathological re-staging, eligible cases were followed up until 30 November 2000. The Kaplan-Meier method was used for survival analysis. COX proportional hazards model was used for prognostic analysis. RESULTS: Of the 532 @entity1 who were enrolled in the study, 268 @entity1 were assigned to lung resection combined with SND and 264 were assigned to lung resection combined with @entity1764 . After surgical restaging only 471 cases were eligible for follow-up. The median survival was 59 months in the group given SND and 34 months in the group given @entity1764 (P=0.0000 by the log rank test). There was significant difference in survival in Stage I (5-year survival 82.16 vs. 57.49%) and Stage IIIA (26.98 vs. 6.18%) by the log rank test and Breslow test. There was no significant yet marginal difference in survival by log rank test (10-year survival 32.04 vs. 26.92%, P=0.0523) but significant difference in survival by Breslow test (5-year survival 50.42 vs. 34.05%, P=0.0284) in Stage II. Types of mediastinal lymph node dissection, pTNM stage, @entity5 size and number of lymph node @entity3 were four factors that influenced long-term survival rate by multivariate analysis. CONCLUSIONS: As compared with @entity1764 , lobectomy (pneumonectomy) combined with SND can improve survival in resectable @entity1149 .
