title: Complete resection via medial sternotomy for non-small cell lung cancer in the right upper lobe.
abstract: BACKGROUND
  Right upper lobectomy with right cervical and bilateral mediastinal lymph node dissection via a median approach was performed for non-small cell lung cancer.
  
  
  METHODS
  From 1995 to 2003, 48 patients aged < or = 70 years underwent resection of cancer in the right upper lobe, including 26 with N0, four with N1 and 18 with N2 disease.
  
  
  RESULTS
  Metastases to the right cervical, highest mediastinal, pretracheal and bilateral tracheobronchial lymph nodes were frequent. There were no operative or hospital deaths. Preoperative accuracy of N-factor diagnosis was only 35.4%. The overall 5-year survival rate was 58.8%. The rate for C-N2 disease (n = 18) was 42.6%, and the rate for p-N2 disease (n = 7) and p-N3 disease (n = 13) was 57.1% and 0%, respectively, using the Kaplan-Meier method.
  
  
  CONCLUSIONS
  Patients without N3 disease have a good prognosis, and extended and systematic radical lymphadenectomy via median sternotomy improves the staging, and possibly the prognosis of pure N2 disease.
authors.affiliation: Department of General Thoracic Surgery, Juntendo University, School of Medicine, Tokyo, Japan. miyagen@med.juntendo.a.jp
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Wang
authors.forename: Ryuta
authors.initials: R
authors.lastname: Fukai
authors.forename: Toshiro
authors.initials: T
authors.lastname: Futagawa
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Anami
authors.forename: Akio
authors.initials: A
authors.lastname: Yamazaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Morio
authors.forename: Enjo
authors.initials: E
authors.lastname: Hata
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods*; D013249:Sternum / Q000601:surgery; D016019:Survival Analysis