Prognostic value of upper paratracheal lymph node resection in stage IB right‑sided lung cancer: A retrospective cohort study

The aim of the present study was to investigate the impact of upper paratracheal lymph node resection on the prognosis of patients with stage IB non-small cell lung cancer (NSCLC). A retrospective analysis of 339 patients with upper lobe stage IB NSCLC who underwent surgery at Sun Yat-Sen University Cancer Center (Guangzhou, China) between 1999 and 2009 was conducted. The Cox regression model was used to investigate prognostic factors. Variables with P<0.1 in univariate analysis were incorporated into multivariate analysis. A 1-to-1 propensity score matching (PSM) was conducted to decrease potential bias when comparing the impact of upper paratracheal lymph node resection on survival outcomes. Following PSM, 202 cases were identified. Kaplan-Meier analysis and log-rank test were used to assess recurrence-free survival (RFS) and overall survival (OS). Of the 339 patients identified, 152 did not undergo resection of upper paratracheal lymph node, while 187 did undergo the surgery. Cases were separated into two groups based on the resection of the upper paratracheal lymph node. Cox regression analysis demonstrated that a family history of malignant tumors and smoking were considered significant prognostic variables for OS. Age and family history of malignant tumors were significant independent prognostic variables for RFS. Resection of the upper paratracheal lymph node was not significantly associated with OS and RFS. Additionally, resection of the upper paratracheal lymph node was not significantly associated with OS and RFS. In conclusion, there was no statistical association between upper paratracheal lymph node resection and OS or RFS for patients with stage IB NSCLC. Therefore, upper paratracheal lymph node resection may not be necessary for patients with early stage NSCLC, and application of this knowledge could reduce unnecessary surgical trauma and decrease lymph node-related complications.