Is completion lobectomy merited for unanticipated nodal metastases after radical segmentectomy for cT1 N0 M0/pN1-2 non-small cell lung cancer?
Is completion lobectomy merited for unanticipated nodal metastases after radical segmentectomy for cT1 N0 M0/pN1-2 non-small cell lung cancer?
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DOI：
10.1016/j.jtcvs.2011.10.045
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发表时间：
2012-04-01
影响因子：
6
通讯作者：
Suzuki, Makoto
中科院分区：
文献类型：
--
作者：
Nomori, Hiroaki;Mori, Takeshi;Suzuki, Makoto
目的：为了检查根治性肺段切除术（定义为广泛的肺门/纵隔淋巴结清扫和足够的手术切缘的肺段切除术）在cT1 N0 M0/pN1 - 2非小细胞肺癌（NSCLC）局部控制中的作用，我们检查了以下内容：（1）由于pN1 - 2疾病，在肺段切除术后进行完全肺叶切除术额外切除的标本中是否观察到转移，以及（2）方法：275例cT1 N0 M0 NSCLC患者行根治性肺段切除术，15例（6%）诊断为pN1或N2病变。结果：10例完整肺叶切除术患者中，无1例在完整肺叶切除术后的标本中发现有残留转移灶。2的5例手术完成与肺段切除术，无论N1或N2的疾病，肿瘤复发，但他们的第一次复发不是local.Conclusions：根治性肺段切除术，广泛的肺门/纵隔淋巴结清扫和足够的手术边缘，可发挥作用，在局部控制cT1 N0 M0/pN1 - 2 NSCLC患者。（《胸血管外科杂志》2012; 143：820 - 4）
Objective: To examine the role of radical segmentectomy, defined as a segmentectomy with extensive hilar/mediastinal lymph node dissection and a sufficient surgical margin, for local control in cT1 N0 M0/pN1-2 non-small cell lung cancer (NSCLC), we examined the following: (1) whether metastases were observed in specimens additionally resected by completion lobectomy undertaken after segmentectomy because of pN1-2 disease and (2) prognostic outcome in patients whose operations were completed with segmentectomy regardless of pN1-2.Methods: Of 275 patients with cT1 N0 M0 NSCLC who were scheduled to undergo radical segmentectomy, 15 (6%) had a diagnosis of pN1 or N2 disease. Of these patients, 10 were additionally treated with completion lobectomy, whereas the operations of the remaining 5 were completed with segmentectomy.Results: None of the 10 patients who underwent completion lobectomy showed residual metastases in the specimens additionally resected by completion lobectomy. Two of the 5 patients whose operations were completed with segmentectomy, regardless of N1 or N2 disease, had tumor recurrence, but their first recurrence was not local.Conclusions: Radical segmentectomy, with extensive hilar/mediastinal lymph node dissection and a sufficient surgical margin, may play a role in local control in patients with cT1 N0 M0/pN1-2 NSCLC. (J Thorac Cardiovasc Surg 2012;143:820-4)