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Station 4L Lymph Node Dissection Versus No Dissection in Clinical Stage I Solid Nodule-Type Invasive NSCLC

5 september 2026 uppdaterad av: Haiquan Chen, Fudan University

A Multicenter Prospective Randomized Controlled Trial of Station 4L Lymph Node Dissection Versus No Dissection in Clinical Stage I Solid Nodule-Type Invasive Non-Small Cell Lung Cancer

This multicenter, prospective, randomized clinical trial will enroll adults aged 18 to 75 years with resectable clinical stage I (T1-T2aN0M0) invasive non-small cell lung cancer presenting as a single solid nodule (consolidation-to-tumor ratio 1.0) in the left lung. After intraoperative frozen-section confirmation of invasive non-small cell lung cancer and completion of standard lung resection and systematic mediastinal lymph node dissection, participants will be randomly assigned 1:1 either to undergo station 4L lymph node dissection or to omit station 4L dissection. The primary hypothesis is that omitting station 4L dissection is noninferior to performing it with respect to 3-year disease-free survival. Secondary outcomes include 3-year overall survival, perioperative complications, 90-day mortality, and station 4L nodal metastasis.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Station 4L lymph nodes are located in a technically challenging area near the aortic arch, left pulmonary artery, thoracic duct, and left recurrent laryngeal nerve. Dissection may improve nodal staging but may also increase operative complexity and complications. This study will evaluate whether station 4L dissection can be omitted without compromising long-term outcomes in patients with early-stage left-sided invasive non-small cell lung cancer.

Eligible participants will undergo complete resection by segmentectomy or lobectomy and systematic mediastinal lymph node dissection. After intraoperative frozen-section confirmation of invasive non-small cell lung cancer, participants will be randomized in a 1:1 ratio to station 4L lymph node dissection or no station 4L dissection. Randomization is stratified by tumor lobe. The planned enrollment is 384 participants, including 258 with left upper lobe tumors and 126 with left lower lobe tumors.

Participants will be followed every 6 months for 3 years after surgery. The primary comparison is 3-year disease-free survival. Secondary assessments include 3-year overall survival, surgery-related complications within 30 days, all-cause mortality within 90 days, and the frequency of station 4L nodal metastasis among participants assigned to station 4L dissection.

Studietyp

Interventionell

Inskrivning (Beräknad)

384

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Kina
    • Xuhui
      • Shanghai, Xuhui, Kina, 200000
        • Rekrytering
        • Fudan University Shanghai Cancer Center
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • Age 18 to 75 years.
  • A single solid pulmonary nodule (consolidation-to-tumor ratio of 1.0) located in the left lung.
  • Resectable clinical stage I (T1-T2aN0M0) non-small cell lung cancer, with a maximum tumor diameter of 4 cm or less, evaluated by positron emission tomography/computed tomography.
  • Planned complete lung resection by segmentectomy or lobectomy with systematic mediastinal lymph node dissection.
  • Intraoperative frozen-section pathological confirmation of invasive non-small cell lung cancer before randomization.
  • Able to provide written informed consent and willing to complete the protocol-specified follow-up.

Exclusion Criteria:

  • Intraoperative or postoperative pathology indicates noninvasive non-small cell lung cancer.
  • Surgical procedure other than segmentectomy or lobectomy.
  • Incomplete tumor resection or residual tumor.
  • History of another malignant tumor.
  • History of previous lung surgery.
  • Previous radiotherapy or chemotherapy for the current lung cancer.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Station 4L Lymph Node Dissection
Participants undergo complete lung resection and systematic mediastinal lymph node dissection, including surgical dissection of station 4L lymph nodes.
Procedur: Station 4L Lymph Node Dissection
During complete lung resection and systematic mediastinal lymph node dissection, all lymphatic and fatty tissue in the station 4L region is surgically removed and submitted for pathological examination. Other mediastinal stations are dissected according to the study protocol in both arms.
Inget ingripande: No Station 4L Lymph Node Dissection
Participants undergo complete lung resection and systematic mediastinal lymph node dissection, but station 4L lymph nodes are not surgically removed.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
3-Year Disease-Free Survival
Tidsram: From enrollment to 3 years
Proportion of participants alive without disease recurrence. A disease-free survival event is the first documented recurrence of non-small cell lung cancer or death from any cause.
From enrollment to 3 years

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
3-Year Overall Survival
Tidsram: From enrollment to 3 years
Proportion of participants alive 3 years after enrollment. Death from any cause is counted as an event.
From enrollment to 3 years
30-Day Surgery-Related Complication Rate
Tidsram: From surgery through postoperative day 30
Proportion of participants with at least one surgery-related complication, graded according to Common Terminology Criteria for Adverse Events version 3.0.
From surgery through postoperative day 30
90-Day All-Cause Mortality
Tidsram: From surgery through postoperative day 90
Proportion of participants who die from any cause within 90 days after surgery.
From surgery through postoperative day 90
Station 4L Lymph Node Metastasis Rate
Tidsram: At postoperative pathological assessment, up to 30 days after surgery
Among participants assigned to station 4L lymph node dissection, the proportion with pathologically confirmed metastasis in resected station 4L lymph nodes.
At postoperative pathological assessment, up to 30 days after surgery

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Fudan University

Utredare

  • Huvudutredare: Haiquan Chen, Fudan University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

15 december 2025

Primärt slutförande (Beräknad)

15 december 2028

Avslutad studie (Beräknad)

15 december 2030

Studieregistreringsdatum

Först inskickad

28 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

28 augusti 2026

Första postat (Faktisk)

3 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

9 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

5 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • ECTOP-1034

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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