Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1983 Sep;198(3):386–397. doi: 10.1097/00000658-198309000-00015

Results of resection in non-oat cell carcinoma of the lung with mediastinal lymph node metastases.

N Martini, B J Flehinger, M B Zaman, E J Beattie Jr
PMCID: PMC1353314  PMID: 6615059

Abstract

From 1974 to 1981, 1598 patients with non-oat cell carcinoma of the lung were seen and treated. All were staged according to the AJC staging system. Of these, 706 patients had evidence of mediastinal lymph node metastases (N2). There were 151 patients (21%) who had complete, potentially curative resection of their primary tumor and all accessible mediastinal lymph nodes. The histologic type of tumor was adenocarcinoma in 94 patients, epidermoid carcinoma in 46 patients, and large-cell carcinoma in 11 patients. The extent of pulmonary resection consisted of a lobectomy in 119 patients, pneumonectomy in 26 patients, and wedge resection or segmentectomy in six patients. Almost all patients also received radiation therapy to the mediastinum. Clinical staging of the primary tumor and the mediastinum was based on the radiographic presentation of the chest and on bronchoscopy. Before treatment, 104 of 151 patients (69%) were believed to have had stage I (90 patients) or II (14 patients) disease, and 47 patients had stage III disease, of whom only 33 had evidence of mediastinal lymph node involvement. Excluding deaths from unrelated causes, the overall survival rate was 74% at 1 year, 43% at 3 years and 29% at 5 years. Survival in patients with clinical stage I or II disease treated by resection was favorable despite the presence of N2 nodes (50% at 3 years). Survival in obvious clinical N2 disease was poor (8% at 3 years). There was no difference in survival between patients with adenocarcinoma and those with epidermoid carcinoma. However, survival was poorer in patients with N2 nodes in the inferior mediastinum compared to those without lymph node involvement at that level.

Full text

PDF
386

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Gralla R. J., Casper E. S., Kelsen D. P., Braun D. W., Jr, Dukeman M. E., Martini N., Young C. W., Golbey R. B. Cisplatin and vindesine combination chemotherapy for advanced carcinoma of the lung: A randomized trial investigating two dosage schedules. Ann Intern Med. 1981 Oct;95(4):414–420. doi: 10.7326/0003-4819-95-4-414. [DOI] [PubMed] [Google Scholar]
  2. Hilaris B. S., Martini N., Nori D., Beattie E. J., Jr The place of radiotherapy in the treatment of lung cancer. World J Surg. 1981 Sep;5(5):675–679. doi: 10.1007/BF01657926. [DOI] [PubMed] [Google Scholar]
  3. Hilaris B. S., Martini N., Nori D., Beattie E. J., Jr The place of radiotherapy in the treatment of lung cancer. World J Surg. 1981 Sep;5(5):675–679. doi: 10.1007/BF01657926. [DOI] [PubMed] [Google Scholar]
  4. Kirsh M. M., Rotman H., Argenta L., Bove E., Cimmino V., Tashian J., Ferguson P., Sloan H. Carcinoma of the lung: results of treatment over ten years. Ann Thorac Surg. 1976 May;21(5):371–377. doi: 10.1016/s0003-4975(10)63881-7. [DOI] [PubMed] [Google Scholar]
  5. Martini N., Beattie E. J., Jr Results of surgical treatment in Stage I lung cancer. J Thorac Cardiovasc Surg. 1977 Oct;74(4):499–505. [PubMed] [Google Scholar]
  6. Martini N., Flehinger B. J., Zaman M. B., Beattie E. J., Jr Prospective study of 445 lung carcinomas with mediastinal lymph node metastases. J Thorac Cardiovasc Surg. 1980 Sep;80(3):390–399. [PubMed] [Google Scholar]
  7. Naruke T., Suemasu K., Ishikawa S. Lymph node mapping and curability at various levels of metastasis in resected lung cancer. J Thorac Cardiovasc Surg. 1978 Dec;76(6):832–839. [PubMed] [Google Scholar]
  8. Paulson D. L. Selection of patients for surgery for bronchogenic carcinoma. Am Surg. 1973 Jan;39(1):1–5. [PubMed] [Google Scholar]
  9. Pearson F. G., DeLarue N. C., Ilves R., Todd T. R., Cooper J. D. Significance of positive superior mediastinal nodes identified at mediastinoscopy in patients with resectable cancer of the lung. J Thorac Cardiovasc Surg. 1982 Jan;83(1):1–11. [PubMed] [Google Scholar]
  10. Pearson F. G., Nelems J. M., Henderson R. D., Delarue N. C. The role of mediastinoscopy in the selection of treatment for bronchial carcinoma with involvement of superior mediastinal lymph nodes. J Thorac Cardiovasc Surg. 1972 Sep;64(3):382–390. [PubMed] [Google Scholar]
  11. Williams D. E., Pairolero P. C., Davis C. S., Bernatz P. E., Payne W. S., Taylor W. F., Uhlenhopp M. A., Fontana R. S. Survival of patients surgically treated for stage I lung cancer. J Thorac Cardiovasc Surg. 1981 Jul;82(1):70–76. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES