Significance of ipsilateral lobar lymph node dissection in the surgical treatment of non-small cell lung cancer with regional lymph node involvement

Cover Page

Abstract


Aim. Analysis of significance of ipsilateral lobar lymph node dissection in the surgical treatment of non-small cell lung cancer with regional lymph node involvement.

Methods. We have analyzed medical records of inpatients and outpatients observed in Republican Clinical Oncology Dispensary of Tatarstan Ministry of Healthcare and operated in 2000-2009. Patients were divided into the groups according to the stage (IB, IIB, IIIA), clinical and anatomic form (peripheral or central cancer), volume of surgery (lobectomy and pulmonectomy) and degree of primary tumor spread and lymph node involvement according to TxNx (T2N0, T2N1, T3N0, T2N2). Total of 803 patients were included. Five-year survival rate in each group was counted by the method of Kaplan-Meier based on volume of surgery (lobectomy and pulmonectomy) and lymph node status (N1, N2).

Results. In peripheral cancer with regional lymph nodes status N1-2 pulmonectomy with removal of ipsilateral lobar lymph nodes is associated with low survival. In central cancer regional lymph node status change from N0 to N1 does not influence survival after lobectomy/pulmonectomy indicating the positive effect of removal of ipsilateral lobar lymph nodes on survival in this group of patients. In central cancer with N2 survival after pulmonectomy decreases by 2 times indicating no influence of removal of ipsilateral lobar lymph nodes on survival in this group of patients.

Conclusion. In peripheral cancer with morphologic confirmation of regional lymph node involvement N1-2, as well as in central cancer with morphologic confirmation of regional lymph node involvement N2, ipsilateral lobar lymph node dissection is irrational; in all other cases (central cancer N0-1 or peripheral cancer N0) ipsilateral lobar lymph node dissection is rational.


A F Gil’metdinov

bozkurt@mail.ru
Regional Emergency Medical Center

V P Potanin

bozkurt@mail.ru
Republican Clinical Oncology Dispensary

  • Международный противораковый союз. TNM. Классификация злокачественных опухолей. 6-е изд. Перевод и ред. Н.Н. Блинова. СПб.: Эскулап. 2003; 243 с.
  • Inoue M., Sawabata N., Takeda S. et al. Results of surgical intervention for p-stage IIIA (N2) non-small cell lung cancer: acceptable prognosis predicted by complete resection in patients with single N2 disease with primary tumor in the upper lobe. J. Thorac. Cardiovasc. Surg. 2004; 127: 1100-1106. doi: 10.1016/j.jtcvs.2003.09.012.
  • Keller S.M., Vangel M.G., Wagner H. et al. Prolonged survival in patients with resected non-small cell lung cancer and single-level N2 disease. J. Thorac. Cardiovasc. Surg. 2004; 128: 130-137. doi: 10.1016/j.jtcvs.2003.11.061.
  • Lardinois D., De Leyn P., Van Schil P. et al. ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer. Eur. J. Cardio-Thorac. Surg. 2006; 30: 787-792. doi: 10.1016/j.ejcts.2006.08.008.
  • Lee J.G., Lee C.Y., Park I.K. et al. The prognostic significance of multiple station N2 in patients with surgically resected stage IIIA N2 non-small cell lung cancer. J. Korean Med. Sci. 2008; 23: 604-608. doi: 10.3346/jkms.2008.23.4.604.
  • Ohta Y., Shimizu Y., Minato H. et al. Results of initial operations in non-small cell lung cancer patients with single-level N2 disease. Ann. Thorac. Sur. 2006; 81: 427-433. doi: 10.1016/j.athoracsur.2005.08.018.
  • Watanabe Sh., Asamura H. Lymph node dissection for lung cancer: significance, strategy and technique. J. Thorac. Oncol. 2009; (4): 652-657. doi: 10.1097/JTO.0b013e31819cce50.

Views

Abstract - 5

PDF (Russian) - 9


© 2017 Gil’metdinov A.F., Potanin V.P.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.