The new strategy of selective nodal dissection for lung cancer based on segment-specific patterns of nodal spread

Shun Ichi Watanabe, Hisao Asamura, Kenji Suzuki, Ryosuke Tsuchiya, P. Van Schil, D. Branscheid, S. Elia, A. Turna, B. Passlick

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

A new strategy for selective nodal dissection in non-small cell lung cancer (NSCLC) patients according to the segment of primary tumor was explored. Data on 504 patients with NSCLC of less than 5 cm, histologically revealed to be N2 disease after thoracotomy, were analyzed. In right upper lobe (RUL) tumor, when the pretracheal node was negative, the incidence of subcarinal involvement was 3.8%. In lower lobe tumor, superior segment (RLL-Superior and LLL-Superior) tumor showed a significantly higher incidence of superior mediastinal involvement than basal segment (RLL-Basal and LLL-Basal) tumor (right, Ps0.0036; left, Ps0.0499). When the subcarinal node was negative, the incidence of superior mediastinal metastasis in RLL-basal and LLL-Basal tumor was 11% and 8%, respectively. In left upper lobe tumor, superior segment (LUL-Superior) tumor showed a significantly lower incidence of subcarinal involvement than lingular segment (LUL-Lingular) tumor (Ps0.0381). When aortic nodes were negative in LUL-Superior tumor, the incidence of subcarinal metastasis was 6%. Collectively, in RUL and LUL-Superior tumors, subcarinal dissection may be unnecessary if superior mediastinal node is negative. In RLLSuperior and LLL-Superior tumors, extensive dissection is required. In RLL-Basal and LLL-Basal tumors, superior mediastinal dissection may be unnecessary if subcarinal node is negative.

Original languageEnglish
Pages (from-to)106-109
Number of pages4
JournalInteractive cardiovascular and thoracic surgery
Volume4
Issue number2
DOIs
Publication statusPublished - 2005 Apr 1
Externally publishedYes

Keywords

  • N2
  • Non-small cell lung cancer
  • Selective nodal dissection
  • Systematic nodal dissection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'The new strategy of selective nodal dissection for lung cancer based on segment-specific patterns of nodal spread'. Together they form a unique fingerprint.

  • Cite this