T1 Stage Non-small-cell Lung Cancer:Characteristics Of Lymph Node Metastasis And The Comparison Of Two Methods Of Treatment

Objective: To investigate the characteristics of lymph node metastasis in T1 stage Non-small-celllung cancer and the effect of minimally invasive surgery and open surgeryMethods: A retrospective analysis was conducted for 240 patients with T1 stage lung cancer(less than 3 cm in diameter)who had undergone lobectomy and systematic lymph node dissection from March 2012 to December 2016 in our hospital.136 cases of minimally invasive surgery group,open surgery group 104 cases.To investigate the number of lymph node metastasis in T1 stage non-small cell lung cancer(NSCLC)and compare two methods of surgery in patients with different tumor size of perioperative related indicators.Results: All patients were successfully completed operation,and no operative deaths.Among them,non-small cell carcinoma(squamous cell carcinoma and adenocarcinoma)were cleaned out of 1368 group of lymph nodes,and the total metastasis rate of N1+N2 was 5.8%(80/1368).The metastatic rate of tumor lymph node metastasis was 3.0%(26/868),and the metastatic rate of tumor lymph node metastasis was 8.3%(34/412),and the metastatic rate was 22.7%(20/88).The lymph node metastasis was 1.0 %(6/622)in the maximum diameter of less than 1.0cm(T1a stage),with no metastasis of squamous cell carcinoma.The metastatic rate of tumor diameter of 1.1-3.0 cm(T1b-c stage)was 9.9%(74/746).For patients with T1 a stage lung cancer,thoracoscope surgery compared with open surgery,postoperative 3 d volume decreased significantly,the chest tube drainage time shortened,and the incidence of pulmonary infection rate,low oxygen syndrome reduce,perioperative complications,postoperative pain significantly reduce 1-3 days.no significant difference in operation time,bleeding volume and number of lymph node dissection.And for T1b-c stage patients,the difference of each index between thoracoscope surgery and open surgery is not big.Conclusion: T1 stage non-small cell lung cancer increased with the tumor size,lymph node metastasis frequency will increase,more active in adenocarcinoma than squamous cell carcinoma,and the lower the degree of tumor differentiation,the greater the frequency of metastasis.T1 a stage patients is more suitable for minimally invasive surgery and the treatment effect had few differences for T1b-c stage patients.