Complete resection via medial sternotomy for non-small cell lung cancer in the right upper lobe.
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.
Miyamoto
Hideaki
H
Department of General Thoracic Surgery, Juntendo University, School of Medicine, Tokyo, Japan. miyagen@med.juntendo.a.jp
Wang
Zhiming
Z
Fukai
Ryuta
R
Futagawa
Toshiro
T
Anami
Yoichi
Y
Yamazaki
Akio
A
Morio
Atsushi
A
Hata
Enjo
E
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