Is completion lobectomy merited for unanticipated nodal metastases after radical segmentectomy for cT1 N0 M0/pN1-2 non-small cell lung cancer?

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• 作者：Hiroaki Nomori ; MD ; PhD^a ; ^{hnomori@qk9.so-net.ne.jp} ; Takeshi Mori ; MD ; PhD^b ; Yotaro Izumi ; MD ; PhD^a ; Mitsutomo Kohno ; MD ; PhD^a ; Kentaro Yoshimoto ; MD ; PhD^b ; Makoto Suzuki ; MD ; PhD^b
• 关键词：10 ; 28
• 刊名：The Journal of Thoracic and Cardiovascular Surgery
• 出版年：2012
• 出版时间：April, 2012
• 年：2012
• 卷：143
• 期：4
• 页码：820-824
• 全文大小：308 K

文摘

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Objective

To examine the role of radical segmentectomy, defined as a segmentectomy with extensive hilar/mediastinal lymph node dissection and a sufficient surgical margin, for local control in cT1 N0 M0/pN1-2 non-small cell lung cancer (NSCLC), we examined the following: (1) whether metastases were observed in specimens additionally resected by completion lobectomy undertaken after segmentectomy because of pN1-2 disease and (2) prognostic outcome in patients whose operations were completed with segmentectomy regardless of pN1-2.

Methods

Of 275 patients with cT1 N0 M0 NSCLC who were scheduled to undergo radical segmentectomy, 15?(6 % ) had a diagnosis of pN1 or N2 disease. Of these patients, 10 were additionally treated with completion lobectomy, whereas the operations of the remaining 5 were completed with segmentectomy.

Results

None of the 10 patients who underwent completion lobectomy showed residual metastases in the specimens additionally resected by completion lobectomy. Two of the 5 patients whose operations were completed with segmentectomy, regardless of N1 or N2 disease, had tumor recurrence, but their first recurrence was not local.

Conclusions

Radical segmentectomy, with extensive hilar/mediastinal lymph node dissection and a sufficient surgical margin, may play a role in local control in patients with cT1 N0 M0/pN1-2 NSCLC.