[Surgical therapeutic strategy for non-small cell lung cancer with (N2) mediastinal lymph node metastasis]. 2006

Guo-jun Huang, and De-kang Fang, and Gui-yu Cheng, and De-chao Zhang
Department of Thoracic Surgical Oncology, Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

OBJECTIVE To evaluate the surgical therapeutic strategy for non-small cell lung cancer (NSCLC) with (N2) mediastinal lymph node metastasis. METHODS The clinical data of 325 patients with N2 NSCLC treated surgically between 1961 and 1995 were analysed. RESULTS The over-all 5-year survival rate was 19.6%. Survival was higher in patients with radical resection than with palliative resection, with squamous-cell carcinoma than with adenocarcinoma, with sleeve lobectomy and pneumonectomy than with regular lobectomy, with 1 to 3 mediastinal metastatic lymph nodes than those over 4, and with adjuvant therapy (chiefly postoperative radiotherapy) than without. All these differences were statistically significant (P < 0.05). There was no 5-year survivor in patients with T3 or T4 tumor, nor in those with distant metastasis. CONCLUSIONS It is suggested that surgery is the best choice for N2 NSCLC patients with T1 or T2 tumor, with non-adenocarcinoma, and with metastatic mediastinal lymph nodes less than 4 in number. Surgery is probably not a good choice in those with T3 tumor varieties. At operation, radical resection of the tumor and systematic removal of all hilar and mediastinal lymph nodes are essential for disease staging and survival improvement. Adjuvant therapy may improve long-term survival and is especially indicated in patients with residual tumor and/or metastatic mediastinal lymph nodes over 3 in number.

UI MeSH Term Description Entries
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008197 Lymph Node Excision Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966) Lymph Node Dissection,Lymphadenectomy,Dissection, Lymph Node,Dissections, Lymph Node,Excision, Lymph Node,Excisions, Lymph Node,Lymph Node Dissections,Lymph Node Excisions,Lymphadenectomies,Node Dissection, Lymph,Node Dissections, Lymph
D008198 Lymph Nodes They are oval or bean shaped bodies (1 - 30 mm in diameter) located along the lymphatic system. Lymph Node,Node, Lymph,Nodes, Lymph
D008207 Lymphatic Metastasis Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system. Lymph Node Metastasis,Lymph Node Metastases,Lymphatic Metastases,Metastasis, Lymph Node
D008297 Male Males
D008482 Mediastinum A membrane in the midline of the THORAX of mammals. It separates the lungs between the STERNUM in front and the VERTEBRAL COLUMN behind. It also surrounds the HEART, TRACHEA, ESOPHAGUS, THYMUS, and LYMPH NODES.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D011013 Pneumonectomy The excision of lung tissue including partial or total lung lobectomy. Bronchoscopic Lung Volume Reduction,Endoscopic Lung Volume Reduction,Lung Volume Reduction,Lung Volume Reduction Surgery,Partial Pneumonectomy,Partial Pneumonectomies,Pneumonectomies,Pneumonectomy, Partial,Reduction, Lung Volume,Volume Reduction, Lung
D002289 Carcinoma, Non-Small-Cell Lung A heterogeneous aggregate of at least three distinct histological types of lung cancer, including SQUAMOUS CELL CARCINOMA; ADENOCARCINOMA; and LARGE CELL CARCINOMA. They are dealt with collectively because of their shared treatment strategy. Carcinoma, Non-Small Cell Lung,Non-Small Cell Lung Cancer,Non-Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinoma,Nonsmall Cell Lung Cancer,Carcinoma, Non Small Cell Lung,Carcinomas, Non-Small-Cell Lung,Lung Carcinoma, Non-Small-Cell,Lung Carcinomas, Non-Small-Cell,Non Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinomas

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