title: Recurrence of mediastinal node cancer after lobe-specific systematic nodal dissection for non-small-cell lung cancer.
abstract: OBJECTIVE
  The standard surgical treatment for patients with non-small-cell lung cancer (NSCLC) is lobectomy with systematic nodal dissection (SND). Lobe-specific patterns of nodal metastases have been recognized, and lobe-specific SND (L-SND) has been reported. We performed L-SND depending on patient-related factors, such as age or the presence of diabetes or respiratory dysfunction, or in the context of specific tumour-related factors, such as the presence of a tumour with a wide area of ground-glass opacity.
  
  
  METHODS
  Between September 2002 and December 2008, 335 consecutive patients with clinical and intraoperative N0 NSCLC underwent curative lobectomies at Shizuoka Cancer Center Hospital. Among these 335 patients, 206 underwent SND (Group A) and 129 underwent L-SND. Of the 129 patients undergoing L-SND, 98 underwent L-SND due to patient-related factors (Group B) and 31 underwent L-SND due to tumour-related factors (Group C).
  
  
  RESULTS
  There were no significant differences in morbidity or blood loss between patients undergoing SND or L-SND, but there was a significant difference in the mean operative times. The 5-year disease-free survival (5-DFS) and 5-year overall survival (5-OS) of patients in Group C were 100%. Although the patients in Group B showed no significant difference in 5-DFS and 5-OS compared with Group A, patients in Group B had significantly more initial recurrence of mediastinal node cancer than did the Group A patients (P = 0.0050).
  
  
  CONCLUSIONS
  The recurrence of mediastinal node cancer in patients undergoing L-SND was significantly greater than that in those undergoing SND.
authors: Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan. to.maniwa@scchr.jp
authors: Tomohiro
authors: T
authors: Maniwa
authors: Takehiro
authors: T
authors: Okumura
authors: Mitsuhiro
authors: M
authors: Isaka
authors: Kazuo
authors: K
authors: Nakagawa
authors: Yasuhisa
authors: Y
authors: Ohde
authors: Haruhiko
authors: H
authors: Kondo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000453:epidemiology*; D008875:Middle Aged; D011013:Pneumonectomy; D012008:Recurrence
keywords: Lobectomy; Lung cancer; Lymph node dissection