TY - JOUR
T1 - Which mediastinal lymph nodes should be examined during operation for diagnosing N0 or N1 disease in bronchogenic carcinoma?
AU - Miyoshi, Shinichiro
AU - Maebeya, Shinji
AU - Suzuma, Takaomi
AU - Bessho, Toshiya
AU - Hirai, Issei
AU - Tanino, Hirokazu
AU - Yoshimasu, Tatsuya
AU - Arimoto, Junji
AU - Naito, Yasuaki
AU - Nishino, Eisei
PY - 1997/8
Y1 - 1997/8
N2 - We retrospectively reviewed the patterns of mediastinal metastasis in relation to the location of the, primary lung cancer in 55 p-N2 patients who underwent resection of the primary lesion and standard mediastinal lymphadenectomy. All (17/17, 100%) were diagnosed as N2 disease based on investigation of nodes 2, 3 and 4 in right upper lobe cancers, 91% (20/22)by examination of nodes 3,7 and 8 in right lower lobe cancers, 91% (10/11) by examination of nodes 4, 5 and 7 in left upper lobe cancers and 100% (5/5) by examination of nodes 4, 7, and 8 in left lower lobe cancers. As a prospective study, these 3 levels were investigated pathologically during operation by selecting one lymph node, which was most strongly suspected to be metastatic, from each level in 61 patients. The N status diagnosed by the frozen sections (f-N) was compared with the N status diagnosed by the permanent sections (p- N) obtained after the standard mediastinal dissection. The f-N was consistent with the p-N in 39 patients with N0 or N1 and in 16 patients with N2 or more. The f-N resulted in under-diagnosis in six patients, four of whom had a micrometastasis at one of the 3 levels. We concluded that the pathological examination of the 3 levels for each lobe during operation is useful to diagnose mediastinal N status and that limited mediastinal lymphadenectomy consisting of the 3 levels can be indicated for patients with negative f-N.
AB - We retrospectively reviewed the patterns of mediastinal metastasis in relation to the location of the, primary lung cancer in 55 p-N2 patients who underwent resection of the primary lesion and standard mediastinal lymphadenectomy. All (17/17, 100%) were diagnosed as N2 disease based on investigation of nodes 2, 3 and 4 in right upper lobe cancers, 91% (20/22)by examination of nodes 3,7 and 8 in right lower lobe cancers, 91% (10/11) by examination of nodes 4, 5 and 7 in left upper lobe cancers and 100% (5/5) by examination of nodes 4, 7, and 8 in left lower lobe cancers. As a prospective study, these 3 levels were investigated pathologically during operation by selecting one lymph node, which was most strongly suspected to be metastatic, from each level in 61 patients. The N status diagnosed by the frozen sections (f-N) was compared with the N status diagnosed by the permanent sections (p- N) obtained after the standard mediastinal dissection. The f-N was consistent with the p-N in 39 patients with N0 or N1 and in 16 patients with N2 or more. The f-N resulted in under-diagnosis in six patients, four of whom had a micrometastasis at one of the 3 levels. We concluded that the pathological examination of the 3 levels for each lobe during operation is useful to diagnose mediastinal N status and that limited mediastinal lymphadenectomy consisting of the 3 levels can be indicated for patients with negative f-N.
KW - Bronchogenic carcinoma
KW - Frozen section examination
KW - Mediastinal lymphadenectomy
KW - Mediastinal metastasis
UR - http://www.scopus.com/inward/record.url?scp=0030930180&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030930180&partnerID=8YFLogxK
U2 - 10.2482/haigan.37.475
DO - 10.2482/haigan.37.475
M3 - Review article
AN - SCOPUS:0030930180
VL - 37
SP - 475
EP - 484
JO - Japanese Journal of Lung Cancer
JF - Japanese Journal of Lung Cancer
SN - 0386-9628
IS - 4
ER -