FACTORS DETERMINING SURVIVAL IN RESECTED N2 LUNG-CANCER

被引：46

作者：

RIQUET, M

MANACH, D

SAAB, M

LEPIMPECBARTHES, F

DUJON, A

DEBESSE, B

机构：

[1] Service de Chirurgie Thoracique, Hôpltal Laennec, Paris, F-75007

[2] Clinique des Cèdres, Saint-Guillaume

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1995年 / 9卷 / 06期

关键词：

LUNG CANCER; SURGERY; LYMPHATICS; TNM;

D O I：

10.1016/S1010-7940(05)80186-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

This retrospective study was based on 237 patients with non-small cell lung cancer (NSCLC) and nodal N2 disease, All accessible mediastinal lymph nodes (LN) were removed and classified according to their anatomical location in LN chains, The pulmonary resections performed were:pneumonectomy (n = 187),lobectomy (rt = 44) and segmentectomy (n=4), There was solitary nodal chain involvement by metastasis in 141 cases, two chains in 72 cases and three or more in 24; ''skip'' metastases were present in 26.6%, N2 disease would have been missed in 45 cases of single chain involvement (31.9%) if routine removal of mediastinal nodes had not been performed, The overall 5-year survival rate was 18.8%, Survival was not influenced by site, size or extension (T) of tumor, tumor histology or the presence of vascular invasion, The prognosis was significantly worsened by the presence of microscopic residual disease (30 cases) and of satellite nodules (23 cases), Survival was significantly improved when metastases involved a single LN chain (26.3 versus 8.3%, P = 0.0003), The location and number of involved nodes in the chain, ''skip'' metastases and the presence of extracapsular spread of carcinoma did not influence the prognosis, Routine mediastinal LN dissection is necessary to improve survival and for classification of lung cancer, Anatomic description allows better understanding of N2 disease which is not a contraindication to surgery when a gross complete resection can be achieved.

引用

页码：300 / 304

页数：5

共 31 条

[1]

Bollen E., Van Duin C.J., Theunissen P., Hof-Grooten-Boer B., Blijam G.H., Mediastinal lymph node dissection in resected lung cancer: Morbidity and accuracy of staging, Ann Thorac Surg, 55, pp. 961-966, (1993)

[2]

Caplan I., Anatomical review of the lymph nodes of the human mediastinum, Surg Radiol Anat, 12, pp. 9-18, (1990)

[3]

Coughlin M., Deslauriers J., Beaulieu M., Fournier B., Piraux M., Rouleau J., Tardif A., Role of mediastinoscopy in pretreatment staging of patients with primary lung cancer, Ann Thorac Surg, 40, pp. 556-560, (1985)

[4]

Cox D.R., Regression models and lifetables (With discussion), J Stat Soc, 34, pp. 187-220, (1972)

[5]

Daly B., Mueller J.D., Faling L.J., Diehl J.T., Bankoff M.S., Karp D.D., Rand W.M., N2 lung cancer: Outcome in patients with false-negative computed tomographic scans of the chest, J Thorac Cardiovasc Surg, 105, pp. 904-911, (1993)

[6]

Deslauriers J., Brisson J., Cartier R., Fournier M., Gagnon D., Piraux M., Beaulieu M., Carcinoma of the lung. Evaluation of satellite nodules as a factor influencing prognosis after resection, J Thorac Cardiovasc Surg, 97, pp. 504-512, (1989)

[7]

Ferguson M.K., De Meester T.R., Deslauriers J., Little A.G., Piraux M., Golomb H., Diagnosis and management of synchronous lung cancer, J Thorac Cardiovasc Surg, 89, pp. 378-385, (1985)

[8]

Hara N., Ohta M., Tanaka K., Ichinose Y., Noge S., Miyazaki K., Ishimatsu T., Assessment of the role of surgery for stage III bronchogenic carcinoma, J Surg Oncol, 25, pp. 153-158, (1984)

[9]

Ishida T., Tateishi M., Kaneko S., Sugimachi K., Surgical treatment of patients with non-small cell lung cancer and mediastinal lymph node involvement, J Surg Oncol, 43, pp. 161-166, (1990)

[10]

Ishida Y., Yano T., Maeda K., Kaneko S., Tateishi M., Sugimachi K., Strategy for lympadenectomy in lung cancer three centimeters or less in diameter, Ann Thorac Surg, 50, pp. 708-713, (1990)

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