Oncological outcomes after lobe-specific mediastinal lymph node dissection via multiport video-assisted thoracoscopic surgery
| Autor: | Junji Ichinose, Yosuke Matsuura, Masayuki Nakao, Mingyon Mun, Sakae Okumura |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment VATS lobectomy Carcinoma Non-Small-Cell Lung medicine Humans Pneumonectomy Lung cancer Pathological Lymph node Neoplasm Staging Retrospective Studies Thoracic Surgery Video-Assisted business.industry General Medicine medicine.disease Surgery Dissection Treatment Outcome medicine.anatomical_structure Mediastinal lymph node Video-assisted thoracoscopic surgery Lymph Node Excision Adenocarcinoma Lymph Nodes Neoplasm Recurrence Local Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 58:i92-i99 |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | OBJECTIVES We retrospectively investigated oncological outcomes after video-assisted thoracoscopic surgery (VATS) lobectomy with lobe-specific mediastinal lymph node dissection (MLND). METHODS Between April 2008 and December 2016, a total of 660 patients underwent VATS lobectomy with lobe-specific MLND for clinical T1-3N0M0 non-small-cell lung cancer, of which 54 (8.2%) patients had pathological node-positive disease (18 N1 and 36 N2). We evaluated their oncological outcomes. RESULTS The predominant histological type was adenocarcinoma (87%). Six (33%) patients in the pN1 and 11 (31%) patients in the pN2 received adjuvant chemotherapy. The median follow-up period was 51.6 months. Postoperative recurrence was observed in 5 (28%) pN1 and 22 (61%) pN2 patients. One (6%) pN1 and 12 (33%) pN2 patients experienced locoregional recurrence. None of the pN1 patient experienced local recurrence at the dissected zone, whereas 11 (31%) pN2 patients had lymph node recurrence, including four at the dissected area and three in the area omitted from dissection in the lobe-specific MLND. The 5-year overall survival rates were 88.1% in the pN1 patients and 80.0% in the pN2 patients; the 5-year recurrence-free survival rates were 63.9% in the pN1 patients and 34.8% in the pN2 patients. In pN2 patients, pathological T classification was a prognostic factor for overall survival (P CONCLUSIONS Recurrence at the omitted zone is an issue for this type of MLND. For pN1 patients, adequate MLND is an important factor for curative treatment. However, for pN2 patients, systemic treatment after recurrence may also contribute to survival. |
| Databáze: | OpenAIRE |
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