Skip Metastasis to the Mediastinal Lymph Nodes in Non-Small Cell Lung Cancer
|
|
- Garry Weaver
- 5 years ago
- Views:
Transcription
1 Skip Metastasis to the Mediastinal Lymph Nodes in Non-Small Cell Lung Cancer Ichiro Yoshino, MD, Hideki Yokoyama, MD, Tokujiro Yano, MD, Takashi Ueda, MD, Eiji Takai, MD, Kazuki Mizutani, MD, Hiroshi Asoh, MD, and Yukito Ichinose, MD Department of Chest Surgery,, National Kvushu Cancer Center, Fukuoka, Japan Background. Whether any difference exists in clinical characteristics between resected non-small cell lung cancer with either skip or ordinary mediastinal lymph node metastases (N2 disease) needs to be clarified. Methods. There were 110 patients with stage IIIA N2 disease. Thirty-three patients demonstrating no metastasis at the hilar nodes [skip (+) group] were compared with the other 77 patients [skip (-) group]. To investigate the extent of nodal involvement, we classified the mediastinal lymph nodes into three regions (superior, inferior, or aortic). Results. There were no significant differences regarding histologic type, T status, or the site of the primary tumors between the skip (+) and the skip (-) N2 groups. In the skip (+) group, mediastinal node metastasis was found in only one region (level 1) in 30 patients (90.9%) and in two regions (level 2) in 3 (9.1%), whereas 28 patients (36.4%) from the skip (-) group revealed mediastinal metastasis at two or three regions (level 2 or 3). The overall survival rate at 5 years after operation was 35% in the skip (+) group and 12.7% in the skip (-) group (p = 0.054). This favorable clinical outcome in the skip (+) group could be explained partially by the higher proportion of patients with level 1 metastases. Furthermore, regarding patients with level 1 disease, the skip (+) group tended to have a better prognosis than the skip (-) group (p = 0.096). Conclusions. These results suggest that patients with skip mediastinal lymph node metastases represent a unique subgroup of N2 disease. (Ann Thorac Surg 1996;62:1021-5) M ediastinal lymph node metastasis (N2 disease) is found in approximately 20% to 40% of patients with non-small cell lung cancer (NSCLC) [1, 2] and is one of the most important adverse factors for prognosis [3]. Until now, many physicians have thought that resection is not indicated when mediastinal lymphatic involvement is found, because of the poor prognostic outcome. However, N2 disease may include various degrees of disease status, such as radiologically detected or undetected disease or mediastinoscopically positive or negative disease, and some of these lesions demonstrate a favorable prognosis after complete surgical resection [4-6]. The hilar lymph nodes are anatomically positioned upstream from the mediastinal lymph nodes; however, N2 disease is also seen without lymph node metastasis in the hilar region, which is called skip metastasis [7, 8]. The clinical significance as well as the basic mechanism of skip metastasis have yet to be clarified. In this study, skip metastasis was found in approximately 30% of the N2 cases. To elucidate the clinical significance of skip mediastinal lymph node metastasis in NSCLC, we compared N2 patients without hilar lymph node metastasis with other N2 patients in terms of the site and extent of mediastinal lymph node metastasis, the Accepted tor publication May 8, Address reprint requests to Dr lchinose, 1)epartment of Chest Surgery, National Kvushu Cancer Center, Notame, Minami-ku, Fukuoka 815, Japan. location of the primary tumor, and the overall survival rate. We also discuss the mechanism of skip metastasis. Material and Methods Patients Between 1982 and 1993, a total of 619 patients with NSCLC underwent operative resection with mediastinal lymph node dissection at the Department of Chest Surgery, National Kyushu Cancer Center. Of these, 110 patients had stage IliA with N2 disease based on the TNM classification [3]. Of these 110 patients, 33 were found to have no metastasis in the hilar lymph node upon histopathologic examination; such cases are referred to as "skip metastasis." The patient profiles are shown in Table 1. The histologic diagnosis of the tumors was based on the criteria of the World Health Organization [9]. All patients had standard operations such as lobectomy or pneumonectomy, with a complete dissection of the hilar and mediastinal lymph nodes. Either computed tomography or a chest roentgenogram revealed N2 disease preoperatively (clinical N2) in 9 patients from the skip (+) group (27.3%) and in 22 from the skip (-) group (28.5%). A complete resection was performed in 30 patients from the skip (--) group (90.9%) and in 68 from the skip (-) group (88.3%), whereas the other patients underwent an incomplete resection because of residual disease. All characteristics described earlier or in Table 1 showed no statistical differences between the groups by The Society of Thoracic Surgeons Published by Elsevier Science Inc PII S (96)
2 1022 YOSHINO ET AL Ann Thorac Surg SKIP NODAL METASTASIS OF LUNG CANCER 1996;62: Table 1. Profile of the Patients" Skip (+) Skip ( ) Characteristic (n - 33) (n 77) Age (y) Range Sex (male/female) 23/10 52/25 Histology., Squamous 16 (48.5%) 24 (31.2%) Adenocarcinoma 16 (48.5%) 48 (62.3%) Large cell 1 (3.0%) 1 (1.3%) Others 0 3 (3.9%) T factor T1 9 (27.3%) 21 (27.3%) T2 20 (60.6%) 47 (61.3 0) T3 4 (12.1%) 9 (11.7%) Clinical N2 9 {27.3%} 22 (28.5%) Location of prima W tumor Right upper 7 (21.2%) 14 {18.2%) Right middle and lower 12 (36.4%) 28 (36.4%) Left upper 10 (33.3%) 24 (31.2%) Left lower 4 (12.1%) 11 (15.6%) Complete resection 30 (90.1%) 68 (88.3%).1 No statistical significance was observed betw een the data of the skip ( + ) and the skip ( ) groups for anv item. Classification of Mediastinal Nodes and Grade qf Mediastinal Metastases The mediastinal lymph nodes were identified by the lymph node map for lung cancer [10] and were classified into three regions as follows: (1) superior nodes, consisting of the highest mediastinal, paratracheal, pretracheal or retrotracheal and tracheobronchial nodes; (2) aortic nodes, consisting of the subaortic and paraaortic nodes; and (3) inferior nodes, consisting of the subcarinal, paraesophageal, and pulmonary ligament nodes. The extent of metastasis in the lymph nodes was scored as follows: level 1, mediastinal node metastasis was proved in one region; level 2, metastasis was found in two regions; and level 3, metastasis was seen in three regions. Follow-Up of Patients In general, a follow-up examination was done every 2 months for the first 2 years and thereafter every 3 to 4 months. The examination included a physical examination, complete blood count, blood chemistry, and chest roentgenography. Although a few patients routinely received screening examinations by computed tomography or radionuclide bone scanning once or twice per year after the operation, the majority of patients underwent computed tomography or a radionuc ide bone scan only when symptoms related to recurrence appeared. Recurrent disease was then confirmed by biopsy if clinically feasible. For patients in whom this was not feasible, radiographic evidence (roentgenography, computed tomography, or radionuclide scan) was accepted. Statistical Analysis The skip (+) and skip ( ) groups were compared regarding several variables, and the differences between them were evaluated using either Student's t test or the X 2 test. Survival curves were prepared using the Kaplan-Meier method and were compared using the log-rank test. The data were considered significant when the p value did not exceed Results Site and Extent of Mediastinal Lymph Node Metastases The sites of metastases to the mediastinal lymph nodes were similar between the skip (+) and skip (-) groups, as demonstrated in Table 2. Metastasis to the superior nodes was observed predominantly in patients with primary tumors in the right upper lobe, and metastasis to the aortic nodes was found frequently in patients with prima~ tumors in the left upper lobe. In the patients with primary tumors located in the right middle or lower lobe, both the superior and inferior nodes were involved by tumor metastasis, regardless of the group. The extent of mediastinal lymph node metastasis is summarized in Table 3. In the skip (+) group, 30 patients (90.9 '0) exhibited level 1 metastasis, and only 3 patients (9.1%) demonstrated level 2 metastasis. On the other hand, the skip (-) group had a significantly higher proportion of level 2 mediastinal metastasis (25 patients, 32.5%) than the skip (+) group. Level 3 metastasis was observed in 3 patients (9.1%) from the skip (-) group but in no patients from the skip (+) group. In the skip (-) Table 2. Sites qf Mediastinal Lymph Node Metastasis Group Skip (+) (n 33) Skip ( ) (n 77) Site of Primary, Tumor Site of Mediastinal Nodal Metastasis Number of Patients Superior Inferior Aortic Right upper lobe Right middle or lower lobe Left upper lobe I Left lower lobe Right upper lobe Right middle or lower lobe Left upper lobe Left lower lobe
3 Ann Thorac Surg YOSHINO ET AL ;62: SKIP NODAL METASTASIS OF LUNG CANCER Table 3. Grade of Mediastinal Lymph Node Metastasis Group Skip (+) (n 33) Skip ( ) (n 77) Site of Primary, Tumor Extent of Mediastinal Nodal Metastasis Number of Patients Right upper lobe Right middle or lower lobe Left upper lobe Left lower lobe Total (90.9%'1) (9.1%6) (0%) Right upper lobe Right middle or h)wer lobe Left upper lobe Left lower lobe Total (63.6%) (32.5%) (3.9%) ' p <: 0.01; t" t; "-: 0.05, between the skip (~) and the skip ( ) groups. group, level 2 or 3 metastasis was especially prevalent in patients with primary tumors located in the right middle or lower lobe (14 of 28, 50%) and in the left upper lobe (12 of 24, 50%), whereas only 1 of 22 patients (4.5%) showed level 2 metastasis in identical subgroups of the skip (+) group. Overall Survival The overall survival curves of both the skip (-) and skip (-) groups are shown in Figure 1. The 5-year overall survival rate was 35% and 13%, respectively. Although the difference did not achieve statistical significance, the skip (+) group was considered to have a better prognosis than the skip (-) group (p ). This result was partially explained by the difference in the proportion of patients with level 1 mediastinal involvement. Of all the patients with N2 disease (110 patients), 79 with level 1 metastasis showed a relatively higher survival rate at 5 years after operation than the 31 patients with level 2 or 3 metastasis (24.6% versus 7.0%; p = 0.116) (Fig 2). More significantly, however, regarding the patients with level 1 metastasis, the skip (+) group also tended to have a Z; 1 O0 50, B Skip (+) (n=33) --Skip (-) (n=77) ~ % 1_ 13% Fig 1. Overall survival cun,es qfi the skip (~) and skip ( ) groups (p ). 6b better prognosis than the skip (-) group (p = 0.096) (Fig 3). The mean number of lymph node stations [10] involved in the patients with level I metastasis was similar between the groups (1.37 per patient in the skip (+) group versus 1.27 in the skip (-) group; p = 0.441). Therefore, other factors may also affect the better prognosis of the skip (+) group. Site of First Recurrence The sites of the first recurrence could be determined in 12 patients from the skip (+) group and in 43 from the skip (-) group. In the skip (+) group, the sites were distant organs in 8 patients, the intrathoracic region in 3, and both sites in 1; in the skip (-) group, the sites were distant organs in 31, local in 10, and both sites in 2. No significant difference was observed in the distribution of the recurrent sites between the groups. Comment In the present study, skip metastasis in mediastinal lymph nodes was recognized in approximately 30% of the resected N2 cases, as reported previously [8]. The skip (+) group demonstrated less mediastinal lymph node involvement than the skip (-) group, which may be one of the reasons why the skip (+) group had a better prognosis than the skip (-) group. These findings indicate that skip mediastinal metastasis is a unique subgroup of N2 disease in NSCLC, and this supports complete dissection of the regional lymph nodes as a standard procedure even though no metastasis is apparent in the hilar lymph nodes at the time of thoracotomy. One possible mechanism of skip metastasis may be the existence of direct lymphatic channels to the mediastinum. Riquet and co-workers [11] reported that subpleural lymphatics have direct passages to the mediastinal lymph nodes in 22.2% of the segments in the right lung and in 25% of the segments in the left lung. These investigators also stated that the direct passages were observed more frequently in the upper lobes [11]. In the present study, however, both the location of the primary
4 1024 YOSHINO ET AL Ann Thorac Surg SKIP NODAl, METASTASIS OF LUNG CANCER 1996;62: tumors and the distribution of the metastatic nodal sites were similar between the skip (+) and the skip (-) groups. These results imply that factors other than anatomic characteristics might also contribute to the skip metastasis phenomenon. For instance, the biologic features of tumor cells or lymph nodes may be considered an important factor of such a phenomenon because the settlement of tumor cells onto lymphatic endothelial cells is mediated by the proliferative potential of tumor cells and by adhesion molecules of both tumor cells and endothelial cells, and thus is affected by the cytokine and growth factor environment [12, 13]. In this study, when comparing patients with the same extent (level 1) of mediastinal metastasis, we found that the skip (+) group showed a longer survival than the skip ( ) group. This result suggests that some such biologic factors are likely related to both the phenomenon of skip mediastinal lymph node metastasis and the favorable outcome of patients with skip mediastinal metastases. Another possible reason for skip nodal metastasis is that small metastatic loci of the hilar lymph nodes are often overlooked in a routine histopathologic examination. In fact, a pathologic examination of the regional lymph nodes is usually performed only at the largest slice of each node, and reevaluations of serial sectioning have revealed up to 20% with false-negative results [14]. Recently, advanced techniques such as immunohistochemistry [15, 16] or polymerase chain reaction [17-19] have been performed in the laboratory to detect micrometastases or circulating tumor cells. Passlik and associates [15] reported that using immunohistochemical techniques, cytokeratin-expressing lung carcinoma cells in the bone marrow were detected in 22.5% of patients who were found to have negative conventional histologic examinations. Gerhard and colleagues [19] demonstrated that polymerase chain reaction techniques can detect a single carcinoembryonic antigen-expressing tumor cell among 2 to normal bone marrow cells. To clarify this issue, such advanced systems should be introduced to improve the detection of micrometastases in the dissected regional lymph nodes. > O ~ ~ Level1 (n=79) [ ~ r 3 (n=31,1) 0 1" '8 Fig 2. Survival curves of patients with level 1 mediastinal invoh,ement arid thos6 with h'vel 2 or 3 (p = 0.116). 1 "1"1 25% L 7% o~ 100 m r~ -~ 5o.> -- skip (+) (n=30) --~1,~(n=49) I I I. 38% h 5Ojo 0 1' '8 60 Fig 3. Survival curves of the patients with level 1 mediastinal metastasis in the skip (+) and skip (-) groups (p = 0.096). In conclusion, patients with NSCLC with skip mediastinal lymph node metastasis are considered to represent a unique subpopulation of N2 disease. Further study is needed to clarify the clinical significance and basic mechanisms of this phenomenon. We thank Dr Brian T. Quinn, Kyushu University, for his critical review and Ms Yumiko Oshima for her expert help in the preparation of the manuscript. References 1. Massen W. Accuracy of mediastinoscopy. In: DeLarue NL, Eschapasse H, eds. International trends in general thoracic surge~. Philadelphia: Saunders, 1985: Martini N, Flehniger BJ, Zaman MB, Beattie EJ Jr. Results of resection in non-oat cell carcinoma of the lung with mediastinal lymph node metastases. Ann Surg 1983;198: Mountain CF. A new international staging system for lung cancer. Chest 1986;89: Miller DL, McManus KG, Allen MS, et al. Results of surgical resection in patients with N2 non-small cell lung cancer. Ann Thorac Surg 1994;57: DaN BT, Mueller JD, Faling LJ, et al. N2 lung cancer: outcome in patients with false-negative computed tomographic scans of the chest. J Thorac Cardiovasc Surg 1993; 105: Patterson GA, Piazza O, Pearson FG, et al. Significance of metastatic disease in subaortic lymph nodes. Ann Thorac Surg 1987;43: lshida T, Yano T, Maeda K, Kaneko S, Tateishi M, Sugimachi K. Strategy for lymphadenectomy in lung cancer three centimeters or less in diameter. Ann Thorac Surg 1990;50: Tateishi M, Fukuyama Y, Hamatake M, Kohdono S, Ishida T, Sugimachi K. Skip mediastinal lymph node metastasis in non-small cell lung cancer. J Surg Oncol 1994;57: The World Health Organization. Histological typing of lung tumors. Am J Clin Pathol 1982;57: Naruke T, Suemasu K, Ishikawa S. Lymph node mapping and curability at various levels of metastasis in resected lung cancer. J Thorac Cardiovasc Surg 1978;76: Riquet M, Hidden G, Debesse B. Direct lymphatic drainage of lung segments to the mediastinal nodes. J Thorac Cardiovasc Surg 1989;97: Fidler IJ. Origin and biology of cancer metastasis. Cytometry 1989;10:
5 Ann Thorac Surg YOSH1NO ET AL ;62: SKIP NODAL METASTASIS OF LUNG CANCER 13. Springer TA. Adhesion receptors of the immune svstem. Nature 1990;346: Gusteron B. Are micrometastases clinically relevant? Br J Hosp Med 1991;47: Mansi JL, Mesker W, van Driel-Kulker AMJ, et al. Automated screening of bone marrow smears for micrometastases. J Immunol Methods 1988;112: Passlick B, Izbicki JR, Kubuschok B, et al. lmmunohistochemical assessment of individual tumor cells in lymph nodes of patients with non-small-cell lung cancer. J Clin Oncol 1994;12: Deifau MH, Kerckaert JP, Collvn H, et al. Detection of minimal residual disease in chronic myeloid leukemia patients after bone marrow transplantation by polymerase chain reaction. Leukemia 1990;4: Smith B, Selby P, Southgate J, et al. Detection of melanoma cells in peripheral blood by means of reverse transcriptase and polymerase chain reaction. Lancet 1991;338: Gerhard M, Juhl H, Kalthoff H, Schreiber HW, Wagener C, Neumaier M. Specific detection of carcinoembryonic antigen-expressing tumor cells in bone marrow aspirates by polymerase chain reaction. J Clin Onco[ 1994;12: Notice From the American Board of Thoracic Surgery The American Board of Thoracic Surgery began its recertificafion process in Diplomates interested in participating in this examination should maintain a documented list of the operations they performed during the year prior to application for recertification. This practice review should consist of I year's consecutive major operative experiences. (If more than 100 cases occur in I year, only 100 need to be listed.} They should also keep a record of their attendance at approved postgraduate medical education activities for the 2 years prior to application. A minimum of 100 hours of approved CME acfiviw is required. In place of a cognitive examination, candidates for recertification will be required to complete both the general thoracic and cardiac portions of the SESATS VI syllabus (Self-Education/Self-Assessment in Thoracic Surgery}. It is not necessary for candidates to purchase SESATS VI booklets prior to applying for recertification. SESATS VI booklets will be forwarded to candidates after their applications have been accepted. Diplomates whose 10-year certificates will expire in 1999 may begin the recertification process in This new certificate will be dated 10 years from the time of expiration of the original certificate. Recertification is also open to any diplomate with an unlimited certificate and will in no wav affect the validiw of the original certificate. The deadline for submission of applications is May 1, A recertification brochure outlining the rules and requirements for recertification in thoracic surgery is available upon request from the American Board of Thoracic Surgery, One Rotary Center, Suite 803, Evanston, IL
MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER
MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER Tsuneyo Takizawa, MD a Masanori Terashima, MD a Teruaki Koike, MD a Hideki Akamatsu, MD a Yuzo
More informationIn non small cell lung cancer, metastasis to lymph nodes, the N factor, is
Okada et al General Thoracic Surgery Border between N1 and N2 stations in lung carcinoma: Lessons from lymph node metastatic patterns of lower lobe tumors Morihito Okada, MD, PhD Toshihiko Sakamoto, MD,
More informationLymph node dissection for lung cancer is both an old
LOBE-SPECIFIC EXTENT OF SYSTEMATIC LYMPH NODE DISSECTION FOR NON SMALL CELL LUNG CARCINOMAS ACCORDING TO A RETROSPECTIVE STUDY OF METASTASIS AND PROGNOSIS Hisao Asamura, MD Haruhiko Nakayama, MD Haruhiko
More informationSuperior and Basal Segment Lung Cancers in the Lower Lobe Have Different Lymph Node Metastatic Pathways and Prognosis
ORIGINAL ARTICLES: Superior and Basal Segment Lung Cancers in the Lower Lobe Have Different Lymph Node Metastatic Pathways and Prognosis Shun-ichi Watanabe, MD, Kenji Suzuki, MD, and Hisao Asamura, MD
More informationTreatment Strategy for Patients With Surgically Discovered N2 Stage IIIA Non-Small Cell Lung Cancer
Treatment Strategy for Patients With Surgically Discovered N2 Stage IIIA Non-Small Cell Lung Cancer Ryoichi Nakanishi, MD, Toshihiro Osaki, MD, Kozo Nakanishi, MD, Ichiro Yoshino, MD, Takashi Yoshimatsu,
More informationLYMPH NODE METASTASIS IN SMALL PERIPHERAL ADENOCARCINOMA OF THE LUNG
LYMPH NODE METASTASIS IN SMALL PERIPHERAL ADENOCARCINOMA OF THE LUNG Tsuneyo Takizawa, MD a Masanori Terashima, MD a Teruaki Koike, MD a Takehiro Watanabe, MD a Yuzo Kurita, MD b Akira Yokoyama, MD b Keiichi
More informationMediastinal Spread of Metastatic Lymph Nodes in Bronchogenic Carcinoma*
Mediastinal Spread of Metastatic Lymph Nodes in Bronchogenic Carcinoma* Mediastinal Nodal Metastases in Lung Cancer Yoh Watanabe, M.D., F.C.C.P.; ]unzo Shimizu, M.D.; Makoto Tsubota, M.D.; and Takashi
More informationThe right middle lobe is the smallest lobe in the lung, and
ORIGINAL ARTICLE The Impact of Superior Mediastinal Lymph Node Metastases on Prognosis in Non-small Cell Lung Cancer Located in the Right Middle Lobe Yukinori Sakao, MD, PhD,* Sakae Okumura, MD,* Mun Mingyon,
More informationImpact of Radical Systematic Mediastinal Lymphadenectomy on Tumor Staging in Lung Cancer
Impact of Radical Systematic Mediastinal Lymphadenectomy on Tumor Staging in Lung Cancer Jakob R. Izbicki, MD, Bernward Passlick, MD, Ortrud Karg, MD, Christian Bloechle, MD, Klaus Pantel, MD, Wolfram
More informationClinical significance of skipping mediastinal lymph node metastasis in N2 non-small cell lung cancer
Original Article Clinical significance of skipping mediastinal lymph node metastasis in N2 non-small cell lung cancer Jun Zhao*, Jiagen Li*, Ning Li, Shugeng Gao Department of Thoracic Surgery, National
More informationLung cancer pleural invasion was recognized as a poor prognostic
Visceral pleural invasion classification in non small cell lung cancer: A proposal on the basis of outcome assessment Kimihiro Shimizu, MD a Junji Yoshida, MD a Kanji Nagai, MD a Mitsuyo Nishimura, MD
More informationThe roles of adjuvant chemotherapy and thoracic irradiation
Factors Predicting Patterns of Recurrence After Resection of N1 Non-Small Cell Lung Carcinoma Timothy E. Sawyer, MD, James A. Bonner, MD, Perry M. Gould, MD, Robert L. Foote, MD, Claude Deschamps, MD,
More informationPrognostic value of visceral pleural invasion in resected non small cell lung cancer diagnosed by using a jet stream of saline solution
Maruyama et al General Thoracic Surgery Prognostic value of visceral pleural invasion in resected non small cell lung cancer diagnosed by using a jet stream of saline solution Riichiroh Maruyama, MD Fumihiro
More informationAlthough ipsilateral intrapulmonary metastasis (PM), Evaluation of TMN Classification for Lung Carcinoma With Ipsilateral Intrapulmonary Metastasis
Evaluation of TMN Classification for Lung Carcinoma With Ipsilateral Intrapulmonary Metastasis Morihito Okada, MD, Noriaki Tsubota, MD, Masahiro Yoshimura, MD, Yoshifumi Miyamoto, MD, and Reiko Nakai,
More informationPrognostic value of visceral pleura invasion in non-small cell lung cancer q
European Journal of Cardio-thoracic Surgery 23 (2003) 865 869 www.elsevier.com/locate/ejcts Prognostic value of visceral pleura invasion in non-small cell lung cancer q Jeong-Han Kang, Kil Dong Kim, Kyung
More informationPrognostic Significance of Extranodal Cancer Invasion of Mediastinal Lymph Nodes in Lung Cancer
Jpn. J. Clin. Oncol. 198, 1 (), 7-1 Prognostic Significance of Extranodal Cancer Invasion of Mediastinal Lymph Nodes in Lung Cancer KEIICHI SUEMASU, M.D. AND TSUGUO NARUKE, M.D. Department of Surgery,
More informationVisceral pleural involvement (VPI) of lung cancer has
Visceral Pleural Involvement in Nonsmall Cell Lung Cancer: Prognostic Significance Toshihiro Osaki, MD, PhD, Akira Nagashima, MD, PhD, Takashi Yoshimatsu, MD, PhD, Sosuke Yamada, MD, and Kosei Yasumoto,
More informationSurgical resection is the first treatment of choice for
Predictors of Lymph Node and Intrapulmonary Metastasis in Clinical Stage IA Non Small Cell Lung Carcinoma Kenji Suzuki, MD, Kanji Nagai, MD, Junji Yoshida, MD, Mitsuyo Nishimura, MD, and Yutaka Nishiwaki,
More informationAlthough the international TNM classification system
Prognostic Significance of Perioperative Serum Carcinoembryonic Antigen in Non-Small Cell Lung Cancer: Analysis of 1,000 Consecutive Resections for Clinical Stage I Disease Morihito Okada, MD, PhD, Wataru
More informationS promise of long-term survival for patients with nonsmall
Aggressive Surgical ntervention in N Non-Small Cell Cancer of the Lung Yoh Watanabe, MD, Junzo Shimizu, MD, Makoto Oda, MD, Yoshinobu Hayashi, MD, Shinichiro Watanabe, MD, Yasuhiko Tatsuzawa, MD, Takashi
More informationIn 1989, Deslauriers et al. 1 described intrapulmonary metastasis
ORIGINAL ARTICLE Prognosis of Resected Non-Small Cell Lung Cancer Patients with Intrapulmonary Metastases Kanji Nagai, MD,* Yasunori Sohara, MD, Ryosuke Tsuchiya, MD, Tomoyuki Goya, MD, and Etsuo Miyaoka,
More informationThe Significance of One-Station N2 Disease in the Prognosis of Patients With Nonsmall-Cell Lung Cancer
ORIGINAL ARTICLES: SURGERY: The Annals of Thoracic Surgery CME Program is located online at http://cme.ctsnetjournals.org. To take the CME activity related to this article, you must have either an STS
More informationPrognostic Factors for Survival of Stage IB Upper Lobe Non-small Cell Lung Cancer Patients: A Retrospective Study in Shanghai, China
www.springerlink.com Chin J Cancer Res 23(4):265 270, 2011 265 Original Article Prognostic Factors for Survival of Stage IB Upper Lobe Non-small Cell Lung Cancer Patients: A Retrospective Study in Shanghai,
More informationLung cancer is a major cause of cancer deaths worldwide.
ORIGINAL ARTICLE Prognostic Factors in 3315 Completely Resected Cases of Clinical Stage I Non-small Cell Lung Cancer in Japan Teruaki Koike, MD,* Ryosuke Tsuchiya, MD, Tomoyuki Goya, MD, Yasunori Sohara,
More informationValue of Systematic Mediastinal Lymph Node Dissection During Pulmonary Metastasectomy
Value of Systematic Mediastinal Lymph Node Dissection During Pulmonary Metastasectomy Florian Loehe, MD, Sonja Kobinger, MD, Rudolf A. Hatz, MD, Thomas Helmberger, MD, Udo Loehrs, MD, and Heinrich Fuerst,
More informationVisceral pleura invasion (VPI) was adopted as a specific
ORIGINAL ARTICLE Visceral Pleura Invasion Impact on Non-small Cell Lung Cancer Patient Survival Its Implications for the Forthcoming TNM Staging Based on a Large-Scale Nation-Wide Database Junji Yoshida,
More informationMarcel Th. M. van Rens, MD; Aart Brutel de la Rivière, MD, PhD, FCCP; Hans R. J. Elbers, MD, PhD; and Jules M. M. van den Bosch, MD, PhD, FCCP
Prognostic Assessment of 2,361 Patients Who Underwent Pulmonary Resection for Non-small Cell Lung Cancer, Stage I, II, and IIIA* Marcel Th. M. van Rens, MD; Aart Brutel de la Rivière, MD, PhD, FCCP; Hans
More informationPrognostic Significance of Metastasis to the Highest Mediastinal Lymph Node in Nonsmall Cell Lung Cancer
Prognostic Significance of Metastasis to the Highest Mediastinal Lymph Node in Nonsmall Cell Lung Cancer Yukinori Sakao, MD, PhD, Hideaki Miyamoto, MD, PhD, Akio Yamazaki, MD, PhD, Tsumin Oh, MD, Ryuta
More informationIntraoperative Radioisotope Sentinel Lymph Node Mapping in Non Small Cell Lung Cancer
Intraoperative Radioisotope Sentinel Lymph Node Mapping in Non Small Cell Lung Cancer Michael J. Liptay, MD, Gregory A. Masters, MD, David J. Winchester, MD, Brian L. Edelman, MD, Ben J. Garrido, BA, Todd
More informationThe accurate assessment of lymph node involvement is
ORIGINAL ARTICLE Which is the Better Prognostic Factor for Resected Non-small Cell Lung Cancer The Number of Metastatic Lymph Nodes or the Currently Used Nodal Stage Classification? Shenhai Wei, MD, PhD,*
More informationSignificance of Metastatic Disease
Significance of Metastatic Disease in Subaortic Lymph Nodes G. A. Patterson, M.D., D. Piazza, M.D., F. G. Pearson, M.D., T. R. J. Todd, M.D., R. J. Ginsberg, M.D., M. Goldberg, M.D., P. Waters, M.D., D.
More informationOmission of Mediastinal Lymph Node Dissection in Lung Cancer: Its Techniques and Diagnostic Procedures
Review Omission of Mediastinal Lymph Node Dissection in Lung Cancer: Its Techniques and Diagnostic Procedures Hiroaki Nomori, MD, PhD, Kazunori Iwatani, MD, Hironori Kobayashi, MD, Atsushi Mori, MD, and
More informationNon small cell lung cancer (NSCLC) with ipsilateral mediastinal
Results of surgical intervention for p-stage IIIA (N2) non small cell lung cancer: Acceptable prognosis predicted by complete resection in patients with single N2 disease with primary tumor in the upper
More informationStaging of lung cancer based on the TNMclassification
The Prognostic Impact of Main Bronchial Lymph Node Involvement in Non-Small Cell Lung Carcinoma: Suggestions for a Modification of the Staging System Yoshihisa Shimada, MD, Masahiro Tsuboi, MD, PhD, Hisashi
More informationSkip Mediastinal Lymph Node Metastasis and Lung Cancer: A Particular N2 Subgroup With a Better Prognosis
Skip Mediastinal Lymph Node Metastasis and Lung Cancer: A Particular N2 Subgroup With a Better Prognosis Marc Riquet, MD, Jalal Assouad, MD, Patrick Bagan, MD, Christophe Foucault, MD, Françoise Le Pimpec
More informationNon-Small Cell Lung Cancer: Disease Spectrum and Management in a Tertiary Care Hospital
Non-Small Cell Lung Cancer: Disease Spectrum and Management in a Tertiary Care Hospital Muhammad Rizwan Khan,Sulaiman B. Hasan,Shahid A. Sami ( Department of Surgery, The Aga Khan University Hospital,
More informationNumber of Metastatic Lymph Nodes in Resected Non Small Cell Lung Cancer Predicts Patient Survival
Number of Metastatic Lymph Nodes in Resected Non Small Cell Lung Cancer Predicts Patient Survival Jin Gu Lee, MD, Chang Young Lee, MD, In Kyu Park, MD, Dae Joon Kim, MD, Seong Yong Park, MD, Kil Dong Kim,
More informationLung cancer is a prevalent health problem worldwide. It is the leading cause
Prognostic factors in resected stage I non small cell lung cancer with a diameter of 3 cm or less: Visceral pleural invasion did not influence overall and disease-free survival Jung-Jyh Hung, MD, a,b Chien-Ying
More informationCarcinoma of the Lung in Women
Carcinoma of the Lung in Marvin M. Kirsh, M.D., Jeanne Tashian, M.A., and Herbert Sloan, M.D. ABSTRACT The 5-year survival of 293 men and of 78 women undergoing pulmonary resection and mediastinal lymph
More informationThe Itracacies of Staging Patients with Suspected Lung Cancer
The Itracacies of Staging Patients with Suspected Lung Cancer Gerard A. Silvestri, MD,MS, FCCP Professor of Medicine Medical University of South Carolina Charleston, SC silvestri@musc.edu Staging Lung
More informationMEDIASTINAL STAGING surgical pro
MEDIASTINAL STAGING surgical pro Paul E. Van Schil, MD, PhD Department of Thoracic and Vascular Surgery University of Antwerp, Belgium Mediastinal staging Invasive techniques lymph node mapping cervical
More informationComparison of complete and minimal mediastinal lymph node dissection for non-small cell lung cancer: Results of a prospective randomized trial
Thoracic Cancer ISSN 1759-7706 ORIGINAL ARTICLE Comparison of complete and minimal mediastinal lymph node dissection for non-small cell lung cancer: Results of a prospective randomized trial Junhua Zhang*,
More informationMediastinal Staging. Samer Kanaan, M.D.
Mediastinal Staging Samer Kanaan, M.D. Overview Importance of accurate nodal staging Accuracy of radiographic staging Mediastinoscopy EUS EBUS Staging TNM Definitions T Stage Size of the Primary Tumor
More informationLymph Node MetastasG Tsuguo Naruke, M.D., Tomoyuki Goya, M.D., Ryosuke Tsuchiya, M.D., and Keiichi Suemasu, M.D.
ORIGINAL ARTICLES The Importance of Surgery to Non-Small Cell Carcinoma of Lung with Mediastinal Lymph Node MetastasG Tsuguo Naruke, M.D., Tomoyuki Goya, M.D., Ryosuke Tsuchiya, M.D., and Keiichi Suemasu,
More informationThe presence of lymph node metastasis is a crucial
Micrometastasis to Lymph Nodes in Stage I Left Lung Cancer Patients Ryoji Kawano, MD, Enjo Hata, MD, Shingo Ikeda, MD, and Hirozo Sakaguchi, MD Surgical Department of Respiratory Center, Mitsui Memorial
More informationACRIN NLST 6654 Primary Lung Cancer. F1/F2 Interval: to (mm-dd-yyyy) 1. Date of diagnosis: (mm-dd-yyyy)
No. F1/F2 Interval: - - 20 to - - 20 (mm-dd-yyyy) 1. Date of diagnosis: - - 20 (mm-dd-yyyy) 2. Samples recorded: ZP Number S-Number 1) 2) 3) 4) (Refer to Form PX, Column 1. In the rare instance of a diagnosis
More informationUtility of PET-CT for detection of N2 or N3 nodal mestastases in the mediastinum in patients with non-small cell lung cancer (NSCLC)
Utility of PET-CT for detection of N2 or N3 nodal mestastases in the mediastinum in patients with non-small cell lung cancer (NSCLC) Poster No.: C-1360 Congress: ECR 2015 Type: Scientific Exhibit Authors:
More informationRisk Factors for Occult Mediastinal Metastases in Clinical Stage I Non-Small Cell Lung Cancer
ORIGINAL ARTICLES: SURGERY: The Annals of Thoracic Surgery CME Program is located online at http://cme.ctsnetjournals.org. To take the CME activity related to this article, you must have either an STS
More informationComplete surgical excision remains the greatest potential
ORIGINAL ARTICLE Wedge Resection for Non-small Cell Lung Cancer in Patients with Pulmonary Insufficiency: Prospective Ten-Year Survival John P. Griffin, MD,* Charles E. Eastridge, MD, Elizabeth A. Tolley,
More informationLung cancer is the most common overall cause of
GENERAL THORACIC Survival in Primary Lung Cancer Potentially Cured by Operation: Influence of Tumor Stage and Clinical Characteristics Gunnar Myrdal, MD, Mats Lambe, MD, PhD, Gunnar Gustafsson, MD, PhD,
More informationPredictive risk factors for lymph node metastasis in patients with small size non-small cell lung cancer
Original Article Predictive risk factors for lymph node metastasis in patients with small size non-small cell lung cancer Feichao Bao, Ping Yuan, Xiaoshuai Yuan, Xiayi Lv, Zhitian Wang, Jian Hu Department
More informationIn the mid 1970s, visceral pleural invasion (VPI) was included
ORIGINAL ARTICLE Tumor Invasion of Extralobar Soft Tissue Beyond the Hilar Region Does Not Affect the Prognosis of Surgically Resected Lung Cancer Patients Hajime Otsuka, MD,* Genichiro Ishii, MD, PhD,*
More informationA Prospective Study of Indications for Mediastinoscopy in Lung Cancer With CT Findings, Tumor Size, and Tumor Markers
GENERAL THORACIC A Prospective Study of Indications for Mediastinoscopy in Lung Cancer With CT Findings, Tumor Size, and Tumor Markers Hideki Kimura, MD, PhD, Naomichi Iwai, MD, PhD, Soichiro Ando, MD,
More informationPULMONARY RESECTION FOR METASTATIC COLORECTAL CANCER: EXPERIENCES WITH 159 PATIENTS
PULMONARY RESECTION FOR METASTATIC COLORECTAL CANCER: EXPERIENCES WITH 159 PATIENTS Shinji Okumura, MD Haruhiko Kondo, MD Masahiro Tsuboi, MD Haruhiko Nakayama, MD Hisao Asamura, MD Ryosuke Tsuchiya, MD
More informationRadiological staging of lung cancer. Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh
Radiological staging of lung cancer Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh Bronchogenic Carcinoma Accounts for 14% of new cancer diagnoses in 2012. Estimated to kill ~150,000
More informationA nonresponding small cell lung cancer combined with adenocarcinoma
Case Report A nonresponding small cell lung cancer combined with adenocarcinoma Hongyang Lu 1,2, Shifeng Yang 3 1 Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung
More informationStandardized transbronchial needle aspiration procedure for intrathoracic lymph node staging of non-small cell lung cancer
Original Article on Transbronchial Needle Aspiration (TBNA) Standardized transbronchial needle aspiration procedure for intrathoracic lymph node staging of non-small cell lung cancer Xu-Ru Jin 1 *, Min
More informationDifference of Sentinel Lymph Node Identification Between Tin Colloid and Phytate in Patients With Non Small Cell Lung Cancer
of Sentinel Lymph Node Identification Between Tin Colloid and Phytate in Patients With Non Small Cell Lung Cancer Hiroaki Nomori, MD, PhD, Yasuomi Ohba, MD, Kentaro Yoshimoto, MD, Hidekatsu Shibata, MD,
More informationP sumed to have early lung disease with a favorable
Survival After Resection of Stage I1 Non-Small Cell Lung Cancer Nael Martini, MD, Michael E. Burt, MD, PhD, Manjit S. Bains, MD, Patricia M. McCormack, MD, Valerie W. Rusch, MD, and Robert J. Ginsberg,
More informationControversy continues to surround the role of surgery for patients
General Thoracic Surgery Keller et al Prolonged survival in patients with resected non small cell lung cancer and single-level N2 disease Steven M. Keller, MD, a Mark G. Vangel, PhD, b Henry Wagner, MD,
More informationSelective lymph node dissection in early-stage non-small cell lung cancer
Review Article Selective lymph node dissection in early-stage non-small cell lung cancer Han Han 1,2, Haiquan Chen 1,2 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai
More informationThe currently used standard cervical mediastinoscopy (SCM)
ORIGINAL ARTICLE The Role of Extended Cervical Mediastinoscopy in Staging of Non-small Cell Lung Cancer of the Left Lung and a Comparison with Integrated Positron Emission Tomography and Computed Tomography
More informationAlthough metastasis in regional lymph nodes is one of
Nodal Occult Metastasis in Patients With Peripheral Lung Adenocarcinoma of 2.0 cm or Less in Diameter Jian Wu, MD, Yasuhiko Ohta, MD, Hiroshi Minato, MD, Yoshio Tsunezuka, MD, Makoto Oda, MD, Yoh Watanabe,
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/21364
More informationIntraoperative pleural lavage cytology after lung resection as an independent prognostic factor for staging lung cancer
Intraoperative pleural lavage cytology after lung resection as an independent prognostic factor for staging lung cancer Yasushi Shintani, MD, hd, a Mitsunori Ohta, MD, hd, a Teruo Iwasaki, MD, hd, a Naoki
More informationState of the art in surgery for early stage NSCLC does the number of resected lymph nodes matter?
Review Article State of the art in surgery for early stage NSCLC does the number of resected lymph nodes matter? Laura Romero Vielva 1, Manuel Wong Jaen 1, José A. Maestre Alcácer 2, Mecedes Canela Cardona
More informationBronchial Carcinoma and the Lymphatic Sump: The Importance of Bronchoscopic Findings
Bronchial Carcinoma and the Lymphatic Sump: The Importance of Bronchoscopic Findings Gordon F. Murray, M.D., Ormond C. Mendes, M.D., and Benson R. Wilcox, M.D. ABSTRACT The lymphatic sump of Borrie is
More informationLymph node metastasis is one of the most important prognostic
ORIGINAL ARTICLE Comparison of Survival and Recurrence Pattern Between Two-Field and Three-Field Lymph Node Dissections for Upper Thoracic Esophageal Squamous Cell Carcinoma Young Mog Shim, MD, Hong Kwan
More informationPredictive risk factors for lymph node metastasis in patients with resected nonsmall cell lung cancer: a case control study
Moulla et al. Journal of Cardiothoracic Surgery (2019) 14:11 https://doi.org/10.1186/s13019-019-0831-0 RESEARCH ARTICLE Open Access Predictive risk factors for lymph node metastasis in patients with resected
More informationTherapeutic value of lymph node dissection for right middle lobe non-small-cell lung cancer
Original Article Therapeutic value of lymph node dissection for right middle lobe non-small-cell lung cancer Hiroaki Kuroda 1,2, Yukinori Sakao 1,2, Mingyon Mun 2, Noriko Motoi 3, Yuichi Ishikawa 3, Ken
More informationVOLUME 19 NUMBER 2 * FEBRUARY 1975
THE ANNALS OF THORACIC SURGERY Journal of The Society of Thoracic Surgeons and the Southern Thoracic Surgical Association VOLUME 9 NUMBER 2 * FEBRUARY 975 Medias tinoscopy Its Application in Central Versus
More informationExercise 15: CSv2 Data Item Coding Instructions ANSWERS
Exercise 15: CSv2 Data Item Coding Instructions ANSWERS CS Tumor Size Tumor size is the diameter of the tumor, not the depth or thickness of the tumor. Chest x-ray shows 3.5 cm mass; the pathology report
More informationValidation of the T descriptor in the new 8th TNM classification for non-small cell lung cancer
Original Article Validation of the T descriptor in the new 8th TNM classification for non-small cell lung cancer Hee Suk Jung 1, Jin Gu Lee 2, Chang Young Lee 2, Dae Joon Kim 2, Kyung Young Chung 2 1 Department
More informationStandard treatment for pulmonary metastasis of non-small
ORIGINAL ARTICLE Resection of Pulmonary Metastasis of Non-small Cell Lung Cancer Kenichi Okubo, MD,* Toru Bando, MD,* Ryo Miyahara, MD,* Hiroaki Sakai, MD,* Tsuyoshi Shoji, MD,* Makoto Sonobe, MD,* Takuji
More informationLong-term Follow-up for Patients with Papillary Thyroid Carcinoma Treated as Benign Nodules
Long-term Follow-up for Patients with Papillary Thyroid Carcinoma Treated as Benign Nodules YASUHIRO ITO, TAKUYA HIGASHIYAMA, YUUKI TAKAMURA, AKIHIRO MIYA, KAORU KOBAYASHI, FUMIO MATSUZUKA, KANJI KUMA
More informationThe predictive accuracy of sentinel nodes mapping in the setting of pulmonary metastasectomy
DOI 10.1007/s10585-016-9834-6 RESEARCH PAPER The predictive accuracy of sentinel nodes mapping in the setting of pulmonary metastasectomy Hyun Koo Kim 1 Kwanghyoung Lee 2 Kook Nam Han 1 Jae Seon Eo 3 Sungeun
More informationSite of Recurrence in Patients. of the Lung Resected for Cure. with Stages I and I1 Carcinoma
Site of Recurrence in Patients with Stages I and I1 Carcinoma of the Lung Resected for Cure Steven C. Immerman, M.D., Robert M. Vanecko, M.D., Willard A. Fry, M.D., Louis R. Head, M.D., and Thomas W. Shields,
More informationPulmonary resection remains the most effective. Survival in Synchronous vs Single Lung Cancer. Upstaging Better Reflects Prognosis
Survival in Synchronous vs Single Lung Cancer Upstaging Better Reflects Prognosis Marcel Th. M. van Rens, MD; Pieter Zanen, MD, PhD; Aart Brutel de la Rivière, MD, PhD, FCCP; Hans R. J. Elbers, MD, PhD;
More informationA case of different EGFR mutations in surgically resected synchronous triple lung cancer
Case Report A case of different EGFR mutations in surgically resected synchronous triple lung cancer Naoki Haratake 1, Mitsuhiro Takenoyama 1, Makoto Edagawa 1, Shinichiro Shimamatsu 1, Ryo Toyozawa 1,
More informationSmall cell lung cancer (SCLC), which represents 20%
ORIGINAL ARTICLES: GENERAL THORACIC Surgical Results for Small Cell Lung Cancer Based on the New TNM Staging System Masayoshi Inoue, MD, Shinichiro Miyoshi, MD, Tsutomu Yasumitsu, MD, Takashi Mori, MD,
More informationcame from a carcinoma and in 12 from a sarcoma. Ninety lesions were intrapulmonary and the as the chest wall and pleura. Details of the primary
Thorax 1982;37:366-370 Thoracic metastases MARY P SHEPHERD From the Thoracic Surgical Unit, Harefield Hospital, Harefield ABSTRACI One hundred and four patients are reviewed who were found to have thoracic
More informationMediastinal Lymph Node Dissection in Resected Lung Cancer: Morbidity and Accuracy of Staging
Mediastinal Lymph Node Dissection in Resected Lung Cancer: Morbidity and Accuracy of Staging Ewald C. M. Bollen, MD, Cees J. van Duin, MD, Paul H. M. H. Theunissen, MD, PhD, Bep E. v. t Hof-Grootenboer,
More informationEndoscopic Ultrasound With Fine-Needle Aspiration in the Diagnosis and Staging of Lung Cancer
Endoscopic Ultrasound With Fine-Needle Aspiration in the Diagnosis and Staging of Lung Cancer Gerard A. Silvestri, MD, Brenda J. Hoffman, MD, Manoop S. Bhutani, MD, Robert H. Hawes, MD, Lynn Coppage, MD,
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationMODE OF SPREAD IN THE EARLY PHASE OF LYMPHATIC METASTASIS IN NON-SMALL-CELL LUNG CANCER: SIGNIFICANCE OF NODAL MICROMETASTASIS
MODE OF SPREAD IN THE EARLY PHASE OF LYMPHATIC METASTASIS IN NON-SMALL-CELL LUNG CANCER: SIGNIFICANCE OF NODAL MICROMETASTASIS Jakob R. Izbicki, MD a,c'a B. Passlick, MD a'c S. B. Hosch, MD d B. Kubuschock,
More informationNumber of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy
CHEST Original Research Number of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy Results of the Randomized, Prospective American College of Surgeons Oncology Group Z0030 Trial LUNG CANCER Gail
More informationThe prognostic significance of central fibrosis of adenocarcinoma
Prognostic Significance of the Size of Central Fibrosis in Peripheral Adenocarcinoma of the Lung Kenji Suzuki, MD, Tomoyuki Yokose, MD, Junji Yoshida, MD, Mitsuyo Nishimura, MD, Kenro Takahashi, MD, Kanji
More informationORIGINAL PAPER. Marginal pulmonary function is associated with poor short- and long-term outcomes in lung cancer surgery
Nagoya J. Med. Sci. 79. 37 ~ 42, 2017 doi:10.18999/nagjms.79.1.37 ORIGINAL PAPER Marginal pulmonary function is associated with poor short- and long-term outcomes in lung cancer surgery Naoki Ozeki, Koji
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our
More informationRole of Surgery in Management of Non Small Cell Lung Cancer. Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City
Role of Surgery in Management of Non Small Cell Lung Cancer Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City Introduction Surgical approach Principle and type of surgery
More informationGUIDELINES FOR CANCER IMAGING Lung Cancer
GUIDELINES FOR CANCER IMAGING Lung Cancer Greater Manchester and Cheshire Cancer Network Cancer Imaging Cross-Cutting Group April 2010 1 INTRODUCTION This document is intended as a ready reference for
More informationHistory of Limited Resection for Non-small Cell Lung Cancer
Review History of Limited Resection for n-small Cell Lung Cancer Haruhiko Nakamura, MD, PhD, 1 Sugishita Kazuyuki, MD, 1 rihito Kawasaki, MD, 1 Masahiko Taguchi, MD, PhD, 1 and Harubumi Kato, MD, PhD 2
More informationMediastinoscopy. EBUS versus Mediastinoscopy?
Mediastinoscopy M.A. Paul, MD, PhD Dept of Surgery VU University Medical Center Amsterdam Perspectives in Lung Cancer, Amsterdam 9 10 March 2012 1 EBUS versus Mediastinoscopy? I had prepared for a Pro
More informationRESEARCH COMMUNICATION. Occult Micrometastasis to Bone Marrow in Early Lung Cancer: A Clinicopathologic Study from West Bengal, India
RESEARCH COMMUNICATION Occult Micrometastasis to Bone Marrow in Early Lung Cancer: A Clinicopathologic Study from West Bengal, India Saumitra Biswas 1*, Supriya Sarkar 2, Jayati Chakraborty 1, Sudipta
More informationInvasion to the visceral pleura is an important component
Diagnosis of Visceral Pleural Invasion by Lung Cancer Using Intraoperative Touch Cytology Yushi Saito, MD, PhD, Yosuke Yamakawa, MD, PhD, Masanobu Kiriyama, MD, PhD, Ichiro Fukai, MD, PhD, Satoshi Kondo,
More informationEXTENDED SLEEVE LOBECTOMY FOR LUNG CANCER: THE AVOIDANCE OF PNEUMONECTOMY
EXTENDED SLEEVE LOBECTOMY FOR LUNG CANCER: THE AVOIDANCE OF PNEUMONECTOMY Morihito Okada, MD Noriaki Tsubota, MD Masahiro Yoshimura, MD Yoshifumi Miyamoto, MD Hidehito Matsuoka, MD, Shinsuke Satake, MD
More informationVariability in Defining T1N0 Non-Small Cell Lung Cancer Impacts Locoregional Failure and Survival
Variability in Defining T1N0 Non-Small Cell Lung Cancer Impacts Locoregional Failure and Survival Mert Saynak, MD, Jessica Hubbs, MS, Jiho Nam, MD, Lawrence B. Marks, MD, Richard H. Feins, MD, Benjamin
More informationMediastinal Lymph Node Dissection Improves Survival in Patients With Stages II and IIIa Non- Small Cell Lung Cancer
J. MAXWELL CHAMBERLAIN MEMORIAL PAPER Mediastinal Lymph Node Dissection Improves Survival in Patients With Stages II and IIIa Non- Small Cell Lung Cancer Steven M. Keller, MD, Sudeshna Adak, PhD, Henry
More informationHiroyasu Ueno, Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
Hiroyasu Ueno, Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki Is Lower Zone Mediastinal Nodal Dissection Always Mandatory for Lung Cancer in the Lower Lobe? Department of
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More information