Remote results of surgical treatment of patients with early stages on non-smal cell lung cancer
Objective. To estimate efficacy of complete systematic mediastinal lymphodissection (CSMLD) in patients, suffering early stages of a non-small cell lung cancer (NSCLC).
Маterials and methods. There were operated 254 patients with NSCLC Stages І, ІІ. Complete dissection of lymphatic nodes (LN) of mediastinum (N2) was performed in 81 patients. The procedure consisted of the lymph nodes excision from the tumor site: from the right side - all paratracheal, bifurcational, paraesophageal LN and those, belonging to pulmonary ligament. From the left side - paratracheal LN were not removed, but dissection of the aortal window LN were done obligatorily.
Results. In the investigation there was established, that conduction of CSMLD have enhanced general 5-year survival in patients, suffering pulmonary cancer Stage І (р = 0.02). CSMLD conduction in patients with NSCLC during pulmonectomy in 3.4 times have enhanced their general 5-year survival (р < 0.001). Administration of adjuvant polychemotherapy in patients, suffering NSCLC Stage ІІ, to whom incomplete mediastinal lymphodissection performed, lead to their statistically trustworthy enhanced 5-year survival.
Conclusion. The CSMLD conduction enhances 5-year survival of patients, suffering early stages of NSCLC.
2. Howington JA, Blum MG, Chang AC, Balekian AA, Murthy SC. Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May; 143(5):278-313.
3. Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P, et al. The IASLC Lung Cancer Staging Project: A Proposal for a New International Lymph Node Map in the Forthcoming Seventh Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2009 May; 4(5):568-77.
4. De Giacomo T, Venuta F, Rendina EA. Role of lymphadenectomy in the treatment of clinical stage I non—small cell lung cancer. Thorac. Surg. Clin. 2007 May; 17(2):217-21.
5. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Non-small cell lung cancer [Internet]. National Comprehensive Cancer Network, January 18, 2017: Proceedings. - Mode of access: www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. - Last access: 2017. - Title from the screen.
6. Vansteenkiste J, Crinò L, Dooms C, Douillard JY, Faivre-Finn C, Lim E, et al. 2nd ESMO Consensus Conference on Lung Cancer: early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up. Ann Oncol. 2014 Aug; 25(8):1462-74.
7. Ishiguro F, Matsuo K, Fukui T, Mori S, Hatooka S, Mitsudomi T. Effect of selective lymph node dissection based on patterns of lobe—specific lymph node metastases on patient outcome in patients with resectable non—small cell lung cancer: A large—scale retrospective cohort study applying a propensity score. J Thorac Cardiovasc Surg. 2010 Apr; 139(4):1001-6.
8. Sugi K, Kobayashi S, Yagi R, Matsuoka T. Usefulness of sentinel lymph node biopsy for the detection of lymph node micrometastasis in early lung cancer. Interact Cardiovasc Thorac Surg. 2008 Oct; 7(5):913-5.
9. Hughes MJ, Chowdhry MF, Woolley SM, Walker WS. In patients undergoing lung resection for non—small cell lung cancer, is lymph node dissection or sampling superior? Interact Cardiovasc Thorac Surg. 2011 Sep; 13(3):311-5.
10. Toker A, Tanju S, Ziyade S, Kaya S, Erus S, Ozkan B, et al. Alternative paratracheal lymph node dissection in left—sided hilar lung cancer patients: comparing the number of lymph nodes dissected to the number of lymph nodes dissected in right-sided mediastinal dissections. Eur J Cardiothorac Surg. 2011 Jun; 39(6):974-80.
11. Verhagen AF, Schoenmakers MC, Barendregt W, Smit H, van Boven WJ, Looijen M, et al. Completeness of lung cancer surgery: is mediastinal dissection common practice? Eur J Cardiothorac Surg. 2012 Apr; 41(4):834-8.
12. Passlick B, Kubuschock B, Sienel W, Thetter O, Pantel K, Izbicki JR. Mediastinal lymphadenectomy in non-small cell lung cancer: effectiveness in patients with or without nodal micrometastases - results of a preliminary study. European Journal of Cardio-Thoracic Surgery. 2002 March 1; 21(3):520-26.
Copyright (c) 2018 Klinicheskaia khirurgiia
This work is licensed under a Creative Commons Attribution 4.0 International License.