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Complete resection via medial sternotomy for non‐small cell lung cancer in the right upper lobe
Author(s) -
Miyamoto Hideaki,
Wang Zhiming,
Fukai Ryuta,
Futagawa Toshiro,
Anami Yoichi,
Yamazaki Akio,
Morio Atsushi,
Hata Enjo
Publication year - 2005
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2005.03614.x
Subject(s) - medicine , lymphadenectomy , surgery , dissection (medical) , lung cancer , lymph node , mediastinal lymph node , median sternotomy , survival rate , pneumonectomy , mediastinum , radiology , cancer , metastasis
Background:  Right upper lobectomy with right cervical and bilateral mediastinal lymph node dissection via a median approach was performed for non‐small cell lung cancer. Methods:  From 1995 to 2003, 48 patients aged ≤ 70 years underwent resection of cancer in the right upper lobe, including 26 with N0, four with N1 and 18 with N2 disease. Results:  Metastases to the right cervical, highest mediastinal, pretracheal and bilateral tracheobronchial lymph nodes were frequent. There were no operative or hospital deaths. Preoperative accuracy of N‐factor diagnosis was only 35.4%. The overall 5‐year survival rate was 58.8%. The rate for C‐N2 disease ( n  = 18) was 42.6%, and the rate for p‐N2 disease ( n  = 7) and p‐N3 disease ( n  = 13) was 57.1% and 0%, respectively, using the Kaplan−Meier method. Conclusions:  Patients without N3 disease have a good prognosis, and extended and systematic radical lymphadenectomy via median sternotomy improves the staging, and possibly the prognosis of pure N2 disease.

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