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Prognosis and segment-specific nodal spread of primary lung cancer in the right lower lobe.
- Source :
- Thoracic Cancer; Nov2015, Vol. 6 Issue 6, p672-677, 6p
- Publication Year :
- 2015
-
Abstract
- Background Although lobe-specific nodal spread of primary lung cancer has been recently described, segment-specific nodal spread remains unclear. We investigated the frequency of hailer and mediastinal lymph node involvement and survival in patients with tumors located in the superior segment ( SS) and basal segment ( BS) in the right lower lobe. Methods Two hundred and sixty-three patients with primary lung cancer originating in the right lower lobe underwent lobectomy with systematic mediastinal lymph node dissection. Patients were categorized into two groups: SS (n = 114) or BS (n = 149). Results Frequencies of metastasis to station 11s and 11i were significantly higher in the SS ( P < 0.0001) and BS groups ( P = 0.022), respectively. Both the SS and BS groups showed a high frequency of subcarinal mediastinal zone (station 7) metastasis (96.9% and 90.6%, respectively; P = 0.271). The frequencies of superior mediastinal zone (station 2 R and 4 R) metastasis were 37.5% in the SS and 35.8% in the BS group ( P = 0.878). In patients with pN2 disease, three-year disease-free survival was significantly shorter in the SS (22.6%) than the BS group (42.1%; P = 0.020). In the BS group, the independent predictive factors of a poor or good prognosis were metastasis to station 11i or skip metastasis, respectively; however, we did not detect an independent prognostic factor in the SS group. In the right lower lung lobe, there was no segment-specific nodal spread. Conclusion When segmentectomy is undertaken, mediastinal lymph node dissection should be performed in proportion to lobectomy. [ABSTRACT FROM AUTHOR]
- Subjects :
- LUNG tumors
ACADEMIC medical centers
ANATOMY
CHI-squared test
SURGICAL excision
FISHER exact test
LYMPH node surgery
MEDIASTINUM
MULTIVARIATE analysis
SURVIVAL
T-test (Statistics)
PROPORTIONAL hazards models
DATA analysis software
DESCRIPTIVE statistics
KAPLAN-Meier estimator
LOG-rank test
PROGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 17597706
- Volume :
- 6
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Thoracic Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 110568377
- Full Text :
- https://doi.org/10.1111/1759-7714.12235