Surgical management of non-small-cell lung cancer with ipsilateral mediastinal node metastasis (N2 disease)

摘要: Abstract Between 1979 and 1989, 876 patients with non-small-cell lung carcinoma were referred to our unit for surgical treatment. One hundred forty-six judged not suitable treatment on clinical, radiologic, or bronchoscopic findings. Cervical mediastinoscopy anterior mediastinotomy (or both) showed that 151 had mediastinal involvement by invasion metastases into the ipsilateral (N2 disease) contralateral (N3 superior lymph nodes therefore deemed inoperable. Except one patient who of a single nodal station at mediastinoscopy, all other ( n=578) undergoing thoracotomy thought, basis computed tomographic scan exploration have N2 disease. Despite efforts avoid surgery disease, routine node dissection disclosed 149 unsuspected Resection was possible in 130 (87.3%) pneumonectomy n=72), bilobectomy n=7), lobectomy n=49), lesser resection n=2). In three incomplete (2.3%), but 127 complete performed (85%). Histologic examination these 72 tumors squamous cell carcinoma, 54 adenocarcinoma, 14 large-cell 9 mixed type. Eight died hospital after thoracotomy. Adjuvant therapy used resection. Complete follow-up obtained 134 mean period 27.25 months (1 116 months). The actuarial 5-year survival those having 20.1%. There statistically significant difference favoring long-term p HORAC C ARDIOVASC S URG 1994;107:19-28)