Results of Initial Operations in Non–Small Cell Lung Cancer Patients With Single-Level N2 Disease

Ohta, Yasuhiko; Shimizu, Yosuke; Minato, Hiroshi; Matsumoto, Isao; Oda, Makoto; Watanabe, Go

doi:10.1016/j.athoracsur.2005.08.018

Cited by 41 publications

(27 citation statements)

References 29 publications

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“…In particular, patients with N2 mediastinal lymph node involvement remain poor candidates for initial surgical resection even if neoplastic invasion is limited to a single mediastinal station [1].…”

Section: Introductionmentioning

confidence: 99%

Endobronchial ultrasound and value of PET for prediction of pathological results of mediastinal hot spots in lung cancer patients

et al. 2008

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SummaryIn the staging of lung cancer with positron emission tomography (PET) positive mediastinal lymph nodes, tissue sampling is required. The performance of transbronchial needle aspiration (TBNA) using linear endobronchial ultrasound (real-time EBUS-TBNA) under local anaesthesia and the value of PET for prediction of pathological results were assessed in that setting. The number of eluded surgical procedures was evaluated. All consecutive patients with suspected/proven lung cancers and FDG-PET positive mediastinal adenopathy were included. If no diagnosis was reached, further surgical sampling was required. Lymph node SUVmax (maximum standardized uptake value) was assessed in patients whose PET was performed in the leading centre. One hundred and six patients were included. The average number of TBNA samples per patient was 4.9 ±1.1. The prevalence of lymph node metastasis was 58%. Sensitivity, accuracy and negative predictive value of EBUS-TBNA in the staging of mediastinal hot spots were 95, 97 and 91%. Patients without malignant lymph node involvement showed lower SUVmax (respective median values of 3.7 and 10.0; p < 0.0001 ). Surgical procedures were eluded in 56% of the patients. Real-time EBUS-TBNA should be preferred over mediastinoscopy as the first step procedure in the staging of PET mediastinal hot spots in lung cancer patients. In case of negative EBUS, surgical staging procedure should be undertaken. The addition of SUVmax cut-off may allow further refinement but needs validation.

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Section: Introductionmentioning

confidence: 99%

Endobronchial ultrasound and value of PET for prediction of pathological results of mediastinal hot spots in lung cancer patients

et al. 2008

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“…Cerfolio and Bryant showed that 5-year survival of patients with unsuspected N2 disease who underwent complete resection, followed by adjuvant therapy, was 35% and patients with single station N2 disease fare better [18]. On the other hand, Ohta et al reported a 5-year survival rate of 27.1% in single level N2-disease NSCLC patients and suggested that initial operation had yet to be validated for patients with this disease [19]. Nevertheless, 5-year survival rates of non-surgery arms reported by some randomised studies range from 14% to 20% and did not exceed 30% [4,5].…”

Section: Discussionmentioning

confidence: 93%

Prognostic value of single nodal zone metastasis in non-small-cell lung cancer☆

Kim

Lee

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…Ohta ve ark. [14] tek istasyon tutulumu olan ameliyat öncesi N2 hastalık tespit edilmi ameliyat ettikleri 94 hastanın be yıllık sa¤kalımını %27.1 ve medyan sa¤kalım süre-sini 22 ay olarak saptadıklarını bildirmilerdir. Cerfolio ve Bryant'ın [15] 2008 yılında yayınladıkla-rı tesadüfi N2 hastalık serisinde tek istasyon tutulumu olan 98 hastanın iki yıllık sa¤kalımlarının %61, be yıllık sa¤kalımlarının ise %26 oldu¤u bildirilmitir.…”

Section: N2unclassified

“…[11,[14][15][16] Süperior mediastinal lenf nodlarına metastaz birçok çalımada kötü sa¤kalım ile ilikili bulunmasına karın bazı çalımalarda aksi sonuçlar elde edilmitir. [16][17][18] Çalımamızda da, süperior mediastinal lenf nodu metastazı saptanan hastalarda genel sa¤kalım oranının %22.2, hastalıksız sa¤kalım oranının %28.6 olarak bulunmasıyla en kötü sa¤kalım oranına sahip oldukları tespit edildi.…”

Section: N2unclassified

Surgical treatment results in patients detected to have single station N2 in lung cancer resection

Kaba¹

2018

FNG & Bilim Tıp Dergisi

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Objectives: This study aims to investigate why "incidental N2" patients were not detected preoperatively and which "incidental N2" patients had superior survival. Patients and methods:The study included 32 patients (26 males, 6 females; mean age 63.5 years; range, 30 to 77 years) detected to have single station mediastinal "incidental N2" lymph node metastasis out of 597 patients operated due to primary lung cancer in the Thoracic Surgery Department of Medical Faculty of Istanbul University between January 2001 and November 2008. Patients were separated into three groups with regard to metastatic lymph node stations: Group 1: patients detected to have metastasis in aorticopulmonary (numbers 5 and 6) lymph nodes (n=5, 15.6%), group 2: patients detected to have metastasis in inferior mediastinal (numbers 7, 8 and 9) lymph nodes (n=18, 56.2%), group 3: patients detected to have metastasis in superior mediastinal (numbers 2 and 4) lymph nodes (n=9, 28.2%). Results: Factors effective on survival and disease-free survival durations were separately analyzed for all patients and groups. In all patients, two-and five-year general survival rates were mean 50.0% and 29.0%, respectively. Five-year general survival rate and disease-free survival rate for groups 1, 2, and 3 were 40.0%-40.0%, 33.3%-44.4%, and 22.2%-28.6%, respectively. A positive and statistically significant relationship was detected between the number of resected lymph nodes and the number of metastatic lymph nodes. Conclusion: Incidental N2 rate was 5.3% in our study. Thus, actual pathological staging could be performed by correct mediastinal dissection methods. Consequently, with the correct staging in terms of N status of patient, suitable adjuvant oncologic treatment was provided to patient in order to increase the survival duration. For this reason, we emphasize the importance of correct intraoperative mediastinal staging. Aortikopulmoner (5 ve 6 numaralı) lenf nodlarında metastaz tespit edilmiş hastalar (n=5; %15.6), grup 2: İnferior mediastinal (7, 8 ve 9 numaralı) lenf nodlarında metastaz tespit edilmiş hastalar (n=18; %56.2), grup 3: Süperior mediastinal (2 ve 4 numaralı) lenf nodlarında metastaz tespit edilmiş hastalar (n=9; %28.2). Bulgular: Tüm hastalar ve gruplar için sağkalım ve hastalıksız sağkalım sürelerini etkileyen faktörler ayrı ayrı analiz edildi. Tüm hastalarda iki ve beş yıllık genel sağkalım oranları sırasıyla ortalama %50.0 ve %29 idi. Beş yıllık genel sağkalım oranı ve hastalıksız sağkalım oranı grup 1, 2 ve 3'te sırasıyla %40.0-%40.0, %33.3-%44.4 ve %22.2-%28.6 idi. Rezeke edilen lenf nodu sayısı ile metastatik lenf nodu sayısı arasında pozitif ve istatistiksel olarak anlamlı bir ilişki tespit edildi. Sonuç: Çalışmamızda tesadüfi N2 oranı %5.3 idi. Böylece, doğru mediastinal diseksiyon yöntemleri ile gerçek patolojik evrelendirme yapılabildi. Bunun sonucunda, hastanın N durumu açısından doğru evrelendirilmesi ile sağkalım süresini artırmak için hastaya uygun adjuvan onkolojik tedavi sağlandı. Bu nedenle, doğru ameliyat sıra...

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Results of Initial Operations in Non–Small Cell Lung Cancer Patients With Single-Level N2 Disease

Abstract: Background: There is still debate regarding the use of surgery in the management of non-small

Cited by 41 publications

References 29 publications

Endobronchial ultrasound and value of PET for prediction of pathological results of mediastinal hot spots in lung cancer patients

Endobronchial ultrasound and value of PET for prediction of pathological results of mediastinal hot spots in lung cancer patients

Prognostic value of single nodal zone metastasis in non-small-cell lung cancer☆

Surgical treatment results in patients detected to have single station N2 in lung cancer resection

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