title: Extent of lung resection in non-small lung cancer with interlobar lymph node involvement.
abstract: BACKGROUND
  Optimal resection type for non-small cell lung cancer (NSCLC) with interlobar lymph node involvement (ILNI) has seldom been reported. To completely resect a NSCLC with ILNI, some surgeons believe that a pneumonectomy is needed.
  
  
  METHODS
  We retrospectively studied 151 patients (147 men, 4 women; mean age 58 ± 8 years, range 34-79) with non-small lung cancer without mediastinal or hilar lymph node metastasis who underwent an anatomic lung resection with systematic lymph node dissection between January 1995 and November 2006. All patients had involvement of the surgical-pathologic interlobar (#11) lymph node: 8 patients had a T1 tumor; 95, T2; 39, T3; and 9, T4. We evaluated the effect of resection type (pneumonectomy in 90 patients versus lobectomy in 61) on their prognosis by univariate and multivariate analyses.
  
  
  RESULTS
  The 5-year survival rate of patients was 61% for the lobectomy and 35% for the pneumonectomy (p = 0.04). We did not find statistically significant differences in sex, median age, distributions of tumor site, histology and differentiation, complete resection rate, N1 involvement status, morbidity and mortality. Patients who underwent the pneumonectomy had larger tumors and more T3 tumors. The T status, multiple levels N1 involvement and histology did not affect survival in the univariate analysis. Multivariate analysis revealed resection type as a significant prognostic factor.
  
  
  CONCLUSIONS
  Pneumonectomy was not necessary in patients with NSCLC and interlobar lymph node involvement that we had discovered intraoperatively.
authors.affiliation: Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Department of Thoracic Surgery, Istanbul, Turkey. mzekigun@gmail.com
authors.forename: Mehmet Zeki
authors.initials: MZ
authors.lastname: Gunluoglu
authors.forename: Adalet
authors.initials: A
authors.lastname: Demir
authors.forename: Akif
authors.initials: A
authors.lastname: Turna
authors.forename: Deniz
authors.initials: D
authors.lastname: Sansar
authors.forename: Huseyin
authors.initials: H
authors.lastname: Melek
authors.forename: Seyyit Ibrahim
authors.initials: SI
authors.lastname: Dincer
authors.forename: Atilla
authors.initials: A
authors.lastname: Gurses
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey