Akademik Veri Yönetim Sistemi
INDIAN JOURNAL OF SURGERY, 2025 (SCI-Expanded)
The role of lymph node (LN) dissection during pulmonary metastasectomy (PM) procedures is still controversial. Therefore, we aimed to analyze the incidence of unexpected mediastinal LN metastasis during PM for various primary tumors and evaluate its prognostic impact in patients with colorectal carcinoma (CRC), which is known to have the highest incidence of metastasis. We retrospectively analyzed the data of 84 patients who had undergone mediastinal LN concomitantly with PM procedure. The incidence of unexpected mediastinal LN metastasis was 15.5% (n = 13). There was a significant difference between the survival curves of the LN ( -) and LN ( +) groups (p = 0.013). Recurrence rates were similar in both groups (7% in the LN ( -) and 7.7% in the LN ( +) group, p = 1). Subgroup analysis revealed a significant difference between the survival curves of the LN ( -) and LN ( +) groups (p = 0.016). The 2-year survival probability was higher in the LN ( -) group compared to the LN ( +) group (0.718 [95% CI: 0.574-0.897] and 0.141 [95% CI: 0.023-0.844], respectively). Cox regression analysis showed that LN positivity is a significant risk factor for mortality in CRC (p = 0.023). The death rate (hazard) in the LN-positive group is 2.99 times higher than in the LN-negative group. Our results indicate that, despite preoperative radiologic evaluation with CT or PET-CT, the incidence of unexpected LN rate remains high after PM. LN positivity is a prognostic factor and is associated with decreased survival following PM, particularly in patients with CRC.