Lymph node sampling in lung cancer: How should it be done?

Tsuguo Naruke, Ryosuke Tsuchiya, Haruhiko Kondo, Haruhiko Nakayama, Hisao Asamura

研究成果: Article

156 引用 (Scopus)

抄録

Objectives: Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is expected to improve local control. We investigate the most effective method of lymph node dissection or sampling. Methods: A retrospectrive study was carried out on 1815 patients who underwent systematic lymph node dissection and complete resection. The lymphatic route of metastatis from each lobe was investigated by examining which nodes had the most likelihood of metastasis, or to find out which is the sentinel lymph node in the case of small sized tumor, suitable for the video assisted thoracic surgery (VATS) approach. Results: At N2 level, distribution of major metastases from each lobe are as follows: right upper lobe tumor, #3 - 12.3% (80/648) and/or #4 - 8% (52/648); right middle lobe tumor, #3 and/or #7 - 16.4% (13/79); right lower lobe tumor, #7 - 13.7% (52/380); left upper lobe tumor, #5 - 12.3% (60/489) and/or #6 - 6.7% (33/489); and left lower lobe tumor, #7 - 11.9% (26/219). Small sized tumor requires lymph node sampling upon staging, and the lymph node most likely to become the first metastasis, i.e. sentinel node, are as follows: regardless of the location of tumor, #12, #11, and/or #10 in N1 level, which means dissection or sampling within these locations of lymph nodes are prerequisite. In N2 level, #3 and/or #4 in right upper lobe tumor, #3 and/or #7 in right middle lobe tumor, #7 in right lower lobe tumor, #5 and/or #6 in left upper lobe tumor, and, #7 in left lower lobe tumor. Conclusions: In clinical T1NO lung cancer, sentinel lymph node sampling should be done first, if the nodes are negative, complete mediastinal lymph node dissection might be omitted. On the other hand, if the sentinel nodes are positive for pathology, complete medistinal lymph node dissection is required for curative resection. Copyright (C) 1999 Elsevier Science B.V.

元の言語English
ジャーナルEuropean Journal of Cardio-thoracic Surgery
16
発行部数SUPPL. 1
DOI
出版物ステータスPublished - 1999 9 1
外部発表Yes

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Lung Neoplasms
Lymph Nodes
Neoplasms
Lymph Node Excision
Neoplasm Metastasis
Video-Assisted Thoracic Surgery
Operative Surgical Procedures
Dissection
Pathology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

これを引用

Lymph node sampling in lung cancer : How should it be done? / Naruke, Tsuguo; Tsuchiya, Ryosuke; Kondo, Haruhiko; Nakayama, Haruhiko; Asamura, Hisao.

:: European Journal of Cardio-thoracic Surgery, 巻 16, 番号 SUPPL. 1, 01.09.1999.

研究成果: Article

Naruke, Tsuguo ; Tsuchiya, Ryosuke ; Kondo, Haruhiko ; Nakayama, Haruhiko ; Asamura, Hisao. / Lymph node sampling in lung cancer : How should it be done?. :: European Journal of Cardio-thoracic Surgery. 1999 ; 巻 16, 番号 SUPPL. 1.
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title = "Lymph node sampling in lung cancer: How should it be done?",
abstract = "Objectives: Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is expected to improve local control. We investigate the most effective method of lymph node dissection or sampling. Methods: A retrospectrive study was carried out on 1815 patients who underwent systematic lymph node dissection and complete resection. The lymphatic route of metastatis from each lobe was investigated by examining which nodes had the most likelihood of metastasis, or to find out which is the sentinel lymph node in the case of small sized tumor, suitable for the video assisted thoracic surgery (VATS) approach. Results: At N2 level, distribution of major metastases from each lobe are as follows: right upper lobe tumor, #3 - 12.3{\%} (80/648) and/or #4 - 8{\%} (52/648); right middle lobe tumor, #3 and/or #7 - 16.4{\%} (13/79); right lower lobe tumor, #7 - 13.7{\%} (52/380); left upper lobe tumor, #5 - 12.3{\%} (60/489) and/or #6 - 6.7{\%} (33/489); and left lower lobe tumor, #7 - 11.9{\%} (26/219). Small sized tumor requires lymph node sampling upon staging, and the lymph node most likely to become the first metastasis, i.e. sentinel node, are as follows: regardless of the location of tumor, #12, #11, and/or #10 in N1 level, which means dissection or sampling within these locations of lymph nodes are prerequisite. In N2 level, #3 and/or #4 in right upper lobe tumor, #3 and/or #7 in right middle lobe tumor, #7 in right lower lobe tumor, #5 and/or #6 in left upper lobe tumor, and, #7 in left lower lobe tumor. Conclusions: In clinical T1NO lung cancer, sentinel lymph node sampling should be done first, if the nodes are negative, complete mediastinal lymph node dissection might be omitted. On the other hand, if the sentinel nodes are positive for pathology, complete medistinal lymph node dissection is required for curative resection. Copyright (C) 1999 Elsevier Science B.V.",
keywords = "Lung cancer, Lymph node sampling, Sentinel lymph node, Systematic nodal dissection",
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T1 - Lymph node sampling in lung cancer

T2 - How should it be done?

AU - Naruke, Tsuguo

AU - Tsuchiya, Ryosuke

AU - Kondo, Haruhiko

AU - Nakayama, Haruhiko

AU - Asamura, Hisao

PY - 1999/9/1

Y1 - 1999/9/1

N2 - Objectives: Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is expected to improve local control. We investigate the most effective method of lymph node dissection or sampling. Methods: A retrospectrive study was carried out on 1815 patients who underwent systematic lymph node dissection and complete resection. The lymphatic route of metastatis from each lobe was investigated by examining which nodes had the most likelihood of metastasis, or to find out which is the sentinel lymph node in the case of small sized tumor, suitable for the video assisted thoracic surgery (VATS) approach. Results: At N2 level, distribution of major metastases from each lobe are as follows: right upper lobe tumor, #3 - 12.3% (80/648) and/or #4 - 8% (52/648); right middle lobe tumor, #3 and/or #7 - 16.4% (13/79); right lower lobe tumor, #7 - 13.7% (52/380); left upper lobe tumor, #5 - 12.3% (60/489) and/or #6 - 6.7% (33/489); and left lower lobe tumor, #7 - 11.9% (26/219). Small sized tumor requires lymph node sampling upon staging, and the lymph node most likely to become the first metastasis, i.e. sentinel node, are as follows: regardless of the location of tumor, #12, #11, and/or #10 in N1 level, which means dissection or sampling within these locations of lymph nodes are prerequisite. In N2 level, #3 and/or #4 in right upper lobe tumor, #3 and/or #7 in right middle lobe tumor, #7 in right lower lobe tumor, #5 and/or #6 in left upper lobe tumor, and, #7 in left lower lobe tumor. Conclusions: In clinical T1NO lung cancer, sentinel lymph node sampling should be done first, if the nodes are negative, complete mediastinal lymph node dissection might be omitted. On the other hand, if the sentinel nodes are positive for pathology, complete medistinal lymph node dissection is required for curative resection. Copyright (C) 1999 Elsevier Science B.V.

AB - Objectives: Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is expected to improve local control. We investigate the most effective method of lymph node dissection or sampling. Methods: A retrospectrive study was carried out on 1815 patients who underwent systematic lymph node dissection and complete resection. The lymphatic route of metastatis from each lobe was investigated by examining which nodes had the most likelihood of metastasis, or to find out which is the sentinel lymph node in the case of small sized tumor, suitable for the video assisted thoracic surgery (VATS) approach. Results: At N2 level, distribution of major metastases from each lobe are as follows: right upper lobe tumor, #3 - 12.3% (80/648) and/or #4 - 8% (52/648); right middle lobe tumor, #3 and/or #7 - 16.4% (13/79); right lower lobe tumor, #7 - 13.7% (52/380); left upper lobe tumor, #5 - 12.3% (60/489) and/or #6 - 6.7% (33/489); and left lower lobe tumor, #7 - 11.9% (26/219). Small sized tumor requires lymph node sampling upon staging, and the lymph node most likely to become the first metastasis, i.e. sentinel node, are as follows: regardless of the location of tumor, #12, #11, and/or #10 in N1 level, which means dissection or sampling within these locations of lymph nodes are prerequisite. In N2 level, #3 and/or #4 in right upper lobe tumor, #3 and/or #7 in right middle lobe tumor, #7 in right lower lobe tumor, #5 and/or #6 in left upper lobe tumor, and, #7 in left lower lobe tumor. Conclusions: In clinical T1NO lung cancer, sentinel lymph node sampling should be done first, if the nodes are negative, complete mediastinal lymph node dissection might be omitted. On the other hand, if the sentinel nodes are positive for pathology, complete medistinal lymph node dissection is required for curative resection. Copyright (C) 1999 Elsevier Science B.V.

KW - Lung cancer

KW - Lymph node sampling

KW - Sentinel lymph node

KW - Systematic nodal dissection

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