Author of

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

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    P1.07-031 - Is lymph node dissection at station 11s necessary in primary lung cancer located in the middle lobe? (ID 2151)

    09:30 - 16:30  |  Author(s): K. Tachibana
    • Abstract

    Background
    Incomplete fissure between right upper and lower lobe must be divided when lymph nodes at station 11s are dissected, and an additional maneuver is required to divide the fissure for middle lobectomy. The purpose of this study was to determine whether or not dissection of station 11s lymph nodes is necessary in the case of lung cancers located in the middle lobe.

    Methods
    Between 2000 and 2012, 1657 patients underwent surgical resection for non-small cell lung cancer (NSCLC). Of these, 112 patients who underwent pulmonary resection greater than lobectomy and systemic lymph node dissection, and who had T1-4N0-2M0 NSCLC in the middle lobe, were analyzed retrospectively. 27 patients had lymph node metastases (N1:13, N2:14).

    Results
    The distribution of lymph node metastasis is shown in Figure 1a and 1b. Lobectomy was performed in 82 patients, lobectomy plus additional lung resection was performed in 8, bilobectomy was performed in 22, and pneumonectomy was performed in two. Six patients underwent bronchial sleeve resection. The overall 5-year survival rate was 80.2% in patients without lymph node metastasis, 11.3% in N1, and 0% in N2 (p<0.0001). Four patients had metastasis to station 11s, and in all of these patients the tumors were located in the lateral segment (S4), were larger than 3 cm in diameter, and showed adenocarcinoma histologically. Three of these four patients underwent bilobectomy. Figure 1Figure 2

    Conclusion
    Lymph node metastasis is a significant prognostic factor for primary lung cancer in the middle lobe. Among patients who had lymph node metastasis in middle-lobe NSCLC, 15% had metastasis to station 11s. Therefore, lymph node dissection of station 11s is required for patients with primary lung cancer located in the middle lobe to ensure accurate staging.