Effect of thoracoscopic right upper mediastinal dissection for left lung cancer-Especially about micrometastasis to lymph nodes-

胸腔镜右上纵隔切除术治疗左肺癌的效果-特别是淋巴结微转移-

基本信息

批准号：
21591819
负责人：
KAWAHARA Katsunobu
金额：
$ 1.83万
依托单位：
Oita University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2009
资助国家：
日本
起止时间：
2009 至 2011
项目状态：
已结题

项目摘要

Background : Survival of patients with stage I non-small cell left lung cancer is not sufficient, probably, because of high incidence of the contralateral mediastinal node involvement. In this study, we investigated retrospectively occult micrometastases to the right upper mediastinal nodes in patients with stage I left lung cancer using a real-time quantitative reverse transcription-polymerase chain reaction(RT-PCR) method. Material and methods : 21 patients with clinical stage I non-small-cell left lung cancer underwent VATS lobectomy and bilateral mediastinal lymph node dissection(BMD). Clinical data and survival of patients with BMD were compared with those of 27 left-unilateral mediastinal node dissection(UMD). Occult micrometastases were detected using cytokeratin 19 mRNA RT-PCR method. Results : The operative time, blood loss, duration of chest tube drainage, and duration of postoperative hospital stay were not different between BMD and UMD patients. Pathological N2 disease was one patients. 20 patients had pN0 disease. Nodal micrometastases of right mediastinum were detected in 9/21(42. 8%) patients. Skip micrometastases to the level N3 nodes without the N1and N2 node involvement was observed in 7/9(77. 8%) patients. Patients with BMD are all alive and have no recurrence during median follow-up period of 13. 9 months. Overall 3-year survival and disease free 3-year survival of BMD patients were not significant difference from those of UMD patients. Conclusion : Thoracoscopic right upper mediastinal dissection for left lung cancer is safe and feasible. In our preliminary study, occult micrometastases to the level N3 nodes occurred frequently in patients with clinical N0 stage I non-small cell left lung cancer. Possibly, postoperative survival of patients with occult micrometastases to the level N3 node is not poor. Further follow up and work are needed.

背景：I期非小细胞左肺癌患者的存活不足，可能是由于对侧纵隔节点受累的高发生率。在这项研究中，我们使用实时定量的逆转录 - 转录酶链反应（RT-PCR）方法对右上纵隔节结节进行了回顾性的隐匿性微量转移。材料和方法：21例临床I期非小细胞左肺癌的患者进行了大桶切除术和双侧纵隔淋巴结清除术（BMD）。将BMD患者的临床数据和存活与27个左侧纵隔节点解剖（UMD）的患者进行了比较。使用细胞角蛋白19 mRNA RT-PCR方法检测神秘微量转移。结果：BMD和UMD患者之间的手术时间，失血，胸管排水的持续时间和术后住院时间没有差异。病理N2疾病是一名患者。 20名患者患有PN0疾病。在9/21（42。8％）患者中检测到右纵隔的淋巴结微量转移。在7/9（77。8％）患者中，观察到没有N1和N2节点受累的N1和N2节点受累的N3节点的微分转移。 BMD患者都活着，在13个月的中位随访期间没有复发。 BMD患者的总体3年生存和无疾病的3年生存与UMD患者的生存率没有显着差异。结论：左肺癌的胸腔镜右上纵隔解剖是安全且可行的。在我们的初步研究中，在临床N0 I期非小细胞左肺癌的患者中经常发生神秘的微型转移。可能，具有神秘微转移到N3级别的术后存活不良。需要进一步跟进，需要工作。

项目成果

期刊论文数量（0）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Usefulness of right upper mediastinal dissection for left lung cancer

右上纵隔切除术对左肺癌的有用性

DOI：
发表时间：
2011
期刊：
影响因子：
0
作者：
K Anami;T Moroga;K Tokuishi;M Kamei;S Suehiro;M Miyawaki;S Takeno;M Chujo;S Yamamoto;S Yamashita;K Kawahara
通讯作者：
K Kawahara

気管壊死に対する外科的治療

气管坏死的手术治疗