Background: Selection of the best lymph node for dissection is a controversial topic in clinical stage-I non-small\ncell lung cancer (NSCLC). Here, we sought to identify the clinicopathologic predictors of regional lymph node\nmetastasis in patients intraoperatively diagnosed with stage-I NSCLC.\nMethods: A retrospective review of 595 patients intraoperatively diagnosed as stage I non-small-cell lung cancer\nwho underwent lobectomy with complete lymph node dissection was performed. Univariate and multivariable\nlogistic regression analysis was performed to determine the independent predictors of regional lymph node\nmetastasis.\nResults: Univariate logistic regression and multivariable analysis revealed three independent predictors of the\npresence of metastatic hilar lymph nodes, five independent predictors for lobe specific mediastinal lymph nodes,\ntwo independent predictors for lobe nonspecific mediastinal lymph nodes and two independent predictors for\nskipping mediastinal lymph nodes.\nConclusions: A complete mediastinal lymph node dissection may be considered for patients suspected of nerve\ninvasion and albumin (> 43.1 g/L) or nerve and vascular invasions. Lobe-specific lymph node dissection should\nprobably be performed for patients suspected of pulmonary membrane invasion, vascular invasion, CEA (> 2.21 ng/\nmL), and tumor (> 1.6 cm) in the right lower lobe or mixed lobes. Hilar lymph node dissection should probably be\nperformed for patients suspected of having bronchial mucosa and cartilage invasion, vascular invasion, and CEA (>\n2.21 ng/mL).
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