Role of lymph node dissection in surgical treatment fornon small cell lung cancer

Do Kim Que

Main Article Content

Abstract

During 10 years from 2004 to 2014 we treat for 94 patients who have NSCLC with N2 were operated in Thong Nhat hospital. Staging was based on AJCC 1997.


Primary outcomes are mortality rate, morbidities. Over all survial, disease freed survival, 5 years survival.


All patients underwent lobectomy or pneumonectomy with lymph node dissection. Adjuvant chemotherapy with platinum based regimen were given for all patients. *


78 patients (83,0%) underwent lobectomy, 2 patients (2,1%) underwent bilobectomy, 3 patients (3,2%) underwent pneumonectomy, 3 patients (3,2%) underwent endoscopic lobecthomy, 8 patients (8,5%) underwent explorative operation. 62 cases (66,0%) have mediastinal lymph node on CT scan before operation. 42 cases (44,7%) with N2 are positive on histologic findings.


No mortality, 1 cases had post operation bleeding, 1 case had atelectasia, 2 cases had prolonged air leak.


5 years survival is 19,1%, in group with N2 positive is 14,3% and in group N2 negative is 23,1%


Thorax CT scan have low sensitives. Positive N2 rate is low among NSCLC N2 detected on operation. Lobectomy/pneumonectomy with lymph node dissection should be done for patient with N2 NSCLC detected on operation.

Article Details

References

1. Besse B, Chevalier TL (2008). Adjuvant Chemotherapy for Non–Small-Cell Lung Cancer: A Fading Effect? Journal of Clinical Oncology 26(31):5014-5017.
2. Betticher DC, Schmitz SH, Totsch M, et al (2003). Mediastinal lymph node clearance after Docetaxel-Cisplatin Neoadjuvant chemotherapy is pronogtic of survival in patient with stage IIIA pN2 Non small cell lung cancer: A multicenter phase II trial. J Clin Oncol 21: 1752-1759.
3. Bonomi P, Kim K, Fairclough D et al, (2000) Comparison of survival and quanlity of life in advanced non-small cell lung cancer patients treated with two dose levels of paclitaxel combined with cisplatin versus etoposide with cisplatin: results of an Eastern Cooperative Oncology Group trial. J Clin Oncol 18(3):623-631.
4. Hainaut P, Ma X, Lacas B, Tsao M et al. (2012). Lace bio pools analysis of the prognostic and predictive value of TP53 mutation in completely resected non small cell lung cancer. Abstract 1192PD ESMO.
5. Mac Manus MP, Hicks RJ, Mathews JP et al, (2003). Positron Emission tomography is superior to computed tomography scanning for response-assessment after radical radiotherapy odr chemotherapy in patients with non-small cell lung cancer. J Clin Oncol. 21:1285-1292
6. Misthos P, Sepsas E, Kokotsakis J, Skottis I, Lioulias A. (2008)The Significance of One-Station N2 Disease in the Prognosis of Patients With Nonsmall-Cell Lung Cancer. Ann Thorac Surg 86:1626 –31.
7. Ohta Y, Oda M, Wu J, Tsunezuka Y, Hiroshi M, Nonomura A, Watanabe G. (2001) Can tumors size be a guide for limitted sugical intervention in patients with peripheral NSCLC. J Thorac Cardiovasc Surg 122: 900 – 906.
8. Okada M, Yamagishi H, Satake S, Matsuoka H, Miyamoto Y, et al. (2000) Suvival related to lymph node involvement in lung cancer after sleeve lobectomy compared to pneumonectomy. J Thorac Cardiovasc Surg 119: 814 – 19.
9. Patel MI, Wakelee HA. (2011). Adjuvant chemotherapy for early stage non-small cell
lung cancer. 1(45):1-4.
10. Rinaldi M, Crino L, Scagliotti GV et al, (2000). A three weeks schedule of gemcitabine-cisplatin in advanced non-small cell lung cancer with two different cisplatin dose levels: A phase II randomized trial. Ann Oncol 11(10):1295-1300.
11. Sandler AB, Numunaitis J, Denham C et al. (2000). PhaseIII trial of gemcitabine plus cisplatin versus cisplatin alone in patients with locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 18(1): 122-130
12. Schiller JH, Harrington D, Sandler A et al, (2000) Arandomized trial of four chemotherapy regimens in advanced non-small cell lung tumors. Proc Am Soc Clin Oncol 18:1a.
13. Sebastian A. Defranchi SA, Cassivi SD, Nichols FC, Allen MS, Shen KR, Deschamps C, Wigle DA. (2009) N2 Disease in T1 Non-Small Cell Lung Cancer. Ann Thorac Surg 88:924 –9.
14. Socinski MA (2003). A dressing the optimal duration of therapy in advanced, metastatic non small cell lung cancer. American society of clinical oncology p144-152
15. Takiguchi Y, Nagao K, Nishiwaki Y et al, (2000). The final results of a randomized phase III trial comparing irrinotecan and cisplatin with vindesine and cisplatin in advanced non-small cell lung cancer. Lung cancer 29(suppl 1):28.
16. Vesselle H, Pugley M, Vallieres E, Wood DE. (2002) The impact of fluorodeoxyglucose F 18 positron-emission tomography on the sugical staging of NSCLC. J Thorac Cardiovasc Surg 124: 511-19.