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Surgical treatment of patients with nonsmall‐cell lung cancer and mediastinal lymph node involvement
Author(s) -
Ishida Teruyoshi,
Tateishi Masahiro,
Kaneko Satoshi,
Sugimachi Keizo
Publication year - 1990
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930430308
Subject(s) - medicine , lung cancer , metastasis , mediastinal lymph node , survival rate , lymph , surgery , lung , lymph node , cancer , radiology , oncology , pathology
Between 1974 and 1988, 115 patients admitted to our surgical unit underwent resection of nonsmall‐cell lung cancer in the presence of mediastinal lymph node involvement (N2 disease). The overall 5 year survival rate was 18%, and the rates in patients with curative and noncurative operation were 26% and 9%, respectively ( P < 0.05). Based on the morphological evidence of N2 disease, the patients were placed in three groups: those with microscopic metastasis, moderate metastasis, and gross metastasis, the incidences being 29%, 28%, and 43%, respectively. The survival rates were 41%, 6%, and 16%, respectively. The difference among microscopic vs. moderate and microscopic vs. gross metastasis was statistically significant ( P < 0.01). Survival rates in patients with intranodal and extranodal invasion, as seen in the histologic examinations, were 34% and 11%, respectively ( P < 0.01). The incidence of gross metastasis and/or extranodal invasion was higher in those who underwent noncurative operation. Postoperatively adjuvant irradiation was not effective in prolonging the survival in patients with curative operation, but the local residual disease was controlled. Therefore, our working criteria are, if N2 lung cancer is present, a complete resection of the primary tumor and the mediastinal lymph nodes should be done. Patients with microscopic metastasis and intranodal invasion can expect a fairly long survival.