The Role of Surgery in N2 Lung Cancer

Martini, Nael; Flehinger, Betty J.

doi:10.1016/s0039-6109(16)44341-0

Cited by 407 publications

(131 citation statements)

References 18 publications

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“…As in the Lung lymph node involvement compared with superior mediastinal lymph node involvement, may be associated Cancer Study Group series, this trial demonstrated that postoperative adjuvant TRT produced a statistiwith improved survival. 11,21 For example, Martini and Flehinger 21 reported that patients who had surgical cally significant decrease in definite local recurrences but no significant improvement in survival compared resection and were found to have upper paratracheal lymph node involvement had a 5-year survival rate of with treatment with surgery alone. However, the subgroup of patients with N2 disease (106 patients) had 20% compared with 32% for those without involvement of the upper mediastinum (P Å 0.13).…”

Section: Discussionmentioning

confidence: 99%

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

Sawyer

Bonner

Gould

et al. 1997

Cancer

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RESULTS.The median follow-up time was 3.5 years for the patients who were alive Hongzhe Li, Ph.D. 4 at the time of the analysis. The surgery alone versus surgery plus TRT groups were 1 Division of Radiation Oncology, well balanced with respect to gender, age, histology, tumor grade, number of Mayo Clinic and Mayo Foundation, Rochester, mediastinal lymph node stations dissected or involved, and involved N1 lymph Minnesota.node number. There were slightly more patients with right lower lobe lesions 2 Division of Thoracic and Cardiovascular Sur-(compared with other lobes), patients with multiple lobe involvement, and patients gery, Mayo Clinic and Mayo Foundation, Rochwith only one N2 lymph node involved in the surgery alone group. After treatment ester, Minnesota.with surgery alone, the actuarial 4-year local recurrence rate was 60%, compared 3 Division of Medical Oncology, Mayo Clinic and with 17% for treatment with adjuvant TRT (P õ 0.0001). The actuarial 4-year Mayo Foundation, Rochester, Minnesota.survival rate was 22% for treatment with surgery alone, compared with 43% for 4 Section of Biostatistics, Mayo Clinic and Mayo treatment with adjuvant TRT (P Å 0.005). On multivariate analysis, the addition Foundation, Rochester, Minnesota.of TRT (P Å 0.0001), absence of superior mediastinal lymph node involvement (P Å 0.005), and fewer N1 lymph nodes involved (P Å 0.02) were independently associated with improved survival rate.CONCLUSIONS. This study, which to the authors' knowledge is the largest evaluating adjuvant TRT in N2 nonsmall cell lung carcinoma, suggests that adjuvant TRT may improve local control and survival.

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Section: Discussionmentioning

confidence: 99%

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

Sawyer

Bonner

Gould

et al. 1997

Cancer

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“…In the SND group, resection was combined with a radical systematic en bloc mediastinal lymph node dissection as described by Naruke (17) and Martini (18). Briefly, in right-sided tumors, the superior mediastinal compartment, contained between the trachea, the superior vena cava from the level of the azygos vein to the right subclavian artery, and the right recurrent laryngeal nerve, was dissected and the trachea, azygos vein, superior vena cava, and ascending aorta were completely freed from all tissue.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Effect of mediastinal lymph nodes sampling in patients with clinical stage I non-small cell lung cancer

et al. 2008

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:Objective : Systematic nodal dissection has been recommended for patients with resectable non-small cell lung cancer because of its staging accuracy. However, in patients with clinical stage I non-small cell lung cancer whether systematic nodal dissection provides more benefits than mediastinal lymph node sampling or not is controversial. In this retrospective study, we evaluated the effect of mediastinal lymph node sampling in patients with clinical stage I NSCLC. Methods : One hundred and nineteen consecutive patients with clinical stage I NSCLC, who underwent curative operation between January 1994 and December 2000, were retrospectively reviewed (dissection group = 58 : sampling group= 61). Systematic nodal dissection was defined as complete removal of mediastinal lymph node, and mediastinal lymph node sampling was defined as removal of lymph node levels 3, 4, and 7 for right-sided tumors and levels 5, 6, and 7 for left-sided tumors. Results : The total number of removed mediastinal lymph nodes in patients who underwent systematic nodal dissection was 22.1 9.7, which was significantly higher than that in patients who underwent mediastinal lymph node sampling of 11.4 7.0 (p 0.001). Postoperatively N2 disease was detected in 8 patients (13.8% %) in the dissection group and 7 (11.5% %) in the sampling group. After the median follow up of 79 months, the cancer specific survival rate at 5 year was 78.0% % in the dissection group and 76.2% % in the sampling group (p = 0.60). Conclusions : Mediastinal lymph node sampling showed the similar effect to systematic nodal dissection in patients with clinical stage I non-small cell lung cancer. J. Med. Invest. 55 : 37-43, February, 2008

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“…[10] Previous studies had reported that the 5-year survival rate of N2-positive NSCLC was around 19.2-30%. [3,6,[11][12][13][14][15][16] In one large recent study, Koshy et al showed that patients with clinical stage IIIA N2 NSCLC, who underwent neoadjuvant chemoradiation followed by lobectomy, were associated with an improved 5-year overall survival up to 33.5%. [17] In our study, the 5-year disease-free and overall survival rates were 16.7 and 40%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in resectable pathological N2 disease of non-small cell lung cancer

Hsieh

Liu

et al. 2015

Biomed J

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The Role of Surgery in N2 Lung Cancer

Cited by 407 publications

References 18 publications

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

Effect of mediastinal lymph nodes sampling in patients with clinical stage I non-small cell lung cancer

Prognostic factors in resectable pathological N2 disease of non-small cell lung cancer

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