Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Results of Resection in N2 Non-Small Cell Lung Cancer

종격동 임파절(N2)에 전이가 있었던 폐암환자의 술후 성적

  • Published : 1994.11.01
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Abstract

This research represents an attempt to study the postoperative results among 32 patients who underwent complete resections of primary lung and involved mediastinal lymph nodes between January 1988 and June 1993. Ages ranged from 34 to 73 years with a mean age of 51.31 $\pm$ 8.17 years. There were 29 male patients[90.6%]. Left lung cancers were more frequent than right lung cancers. There were 19 cases of left lung cancers accounting for 59.4% of the total lung cancers. The difference, however, was insignificant. There was no T1 lesion. T2 and T3 lesions were 21[65.6%] and 11 cases[34.4%], respectively. As for cell type, squamous cell carcinomas were reported in 25 cases making up 78.1% of the cell types. Pneumonectomy was conducted on 20[62.5%] cases. Lobectomy and sleeve lobectomy were conducted on 12[37.5%] cases respectively. Mediastinal lymph node involvemednts were most frequent in subcarinal lymph node[9/13] among right lung cancers, while subaortic lymph noce[12/19] was most frequent among left lung cancers. Postoperative complications were reported in 18.9% of the total cases, including 2 cases each of paralysis of the recurrent laryngeal nerve and 1 case each of chylothorax and pyothorax. They were more frequent among patients who underwent pneumonectomy. The operative mortality stood at 3.1% with 1 patient who underwent pneumonectomy dying of pulmonary edema. The 1-year and 5-year survival rates were 50.8% and 30.1%, respectively. Patients treated with squamous cell carcinoma, involvement of single level mediastinal lymph node and lobectomy showed a higher level of survival. These fidings suggest that a long-term survival can be expected of a considerable number of N2 non-small cell lung cancer patients with a selective complete surgical resection of primary lung cancers involved mediastinal lymph nodes.

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References

  1. Chest v.89 A new international staging system for lung cancer Mountain,C.F.
  2. Surg Clin North Am v.67 The rule of surgery in N2 lung cancer Martini,N.;Flehinger,B.J.
  3. Ann Thorac surg v.51 Aggressibe surgical intervention in N2 non-small cell cancer of the lung Watanabe,Y.;Shimizu,J.;Oda,M.(et al.)
  4. Ann Thorac Surg v.46 The importance of surgery to non-small cell carcinoma of the lung with mediastinal lymph node metastasis Naruka,t.;Goya,T.;Tsuchya,R.(et al.)
  5. J Thorac Cardiovasc Surg v.99 The significance of ipsilateral mediastinal lymph node metastasis (N2 disease) in non-small cell carcinoma of the lung Shields,T.W.
  6. Am J Clin Oncol v.8 Characteristics of long term survivors after treatment of inoperable carcinoma of the lung Komaki,R.;Cox,J.D.;Harts,H.J.(et al.)
  7. J Thorac Cardiovasc Surg v.83 Significance of positive superior mediastinal nodes identified at mediastinoscopy in patients with resectable cancer of the lung Pearson,F.G.;DeLarue,N.C.;Ilves,R.;Todd,T.R.J.;Cooper,J.D.
  8. Ann Thorac Surg v.40 Role of mediastinoscopy in pretreatment staging of patients with primary lung cancer Coughlin,M.;Deslauriers,J.;Beaulieu,M.(et al.)
  9. Ann Surg v.198 Results of resection in non-small cell carcinoma of the lung with mediastinal lymph node metastates Martini,N.;Flehinger,B.J.;Zaman,M.B.;Beattie,E.J.
  10. Chest v.100 Mediastinal nodal involvement and prognisis of non-small cell lung cancer Watanabe,Y.;Hayashi,Y.;Shimizu,J.;Oda,M.;Iwa,T.
  11. Ann Thorac Surg v.43 Significance of metastatic disease in subaortic lymph nodes Patterson,G.A.;Piazza,D.;Pearson,F.G.(et al.)
  12. Chest v.90 Patterns of mediastinal metastases in bronchogenic carcinoma Libshitz,H.I.;McKenna,R.J.Jr;Mountain,C.F.
  13. Lung Cancer v.4 no.SUP. Extended radical operation for N2 left lung cancer through median sternotomy Naruka,T.;Goya,T.;Tsuchiya,R.;Suemasu,K.
  14. Lung Cancer v.7 no.SUP. Systemic bilateral mediastinal dissection and en bloc pulmonary resection through the median sternotomy Hata,E.;Miyasmoto,H.;Mitoma,Y.;Hayakawa,K.
  15. J Clin Oncol v.4 Surgical adjuvant therapy for stage II and stage III adenocarcinoma and large cell undifferentiated carcinoma Holmes,E.C.;Gail,M.
  16. Americal Collage of Surgerons Clinical Congress Combined modality treatment for non-small cell lung cancer. Presented at the Thoracic Postgraduate Course Bonomi,P.
  17. J Thorac Cardiovasc Surg v.86 Modern thirty-day operative mortality for surgical resection in lung cancer Ginberg,R.J.;Hill,L.D.;Eagan,R.T.(et al.)