[Rationale for surgical treatment of cancer of the lower pulmonary lobe with consideration for regional metastatic spread].
Optimal extent of surgery for lung cancer is determined to a great degree by lymph drainage and regional metastases vis-a-vis tumor localization in the lobes. Data on surgical treatment of 505 cases of cancer of the lower lobe are presented. The study established such peculiarities of metastatic spread to mediastinal lymph collector as relatively frequent involvement of the lower mediastinal lymph nodes ("jumping" metastases included) and greater likelihood of spread to the superior mediastinal lymph nodes when those of radix pulmonis are involved. The latter should be interpreted as an indicator of lower lobe involvement. We established the significance of relatively worse prognosis for mediastinal lymph node involvement as well as high frequency of intrasternal recurrences of tumors located in the left lung. The prevailing evidence on partial resections of the right lung rather than lower bilobectomy and the good results of bilobectomies for stage T1-3N1-2 tumors suggest that conservative treatment might offer more advantage in managing cancer of the lower lobe of the right lung. Extended surgery entails lower incidence of intrasternal recurrence and is more effective when used to treat right-lung tumors.
Barchuk
A S
AS
Ergnian
S M
SM
Wagner
R I
RI
Keller
Iu M
IuM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D011013:Pneumonectomy; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome