小面积周围型非小细胞肺癌患者在有意分段切除术中的淋巴结切除范围

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-12-20 Epub Date: 2023-04-25 DOI:10.5761/atcs.oa.22-00216
Tomohiro Maniwa, Masayuki Ohue, Yasushi Shintani, Jiro Okami
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引用次数: 1

摘要

目的:分段切除术和纵隔淋巴结清扫术(MLND)正在成为小范围 NSCLC 的标准手术方法:我们研究了422例接受肺叶切除术和MLND(特定肺叶或系统性)的小范围NSCLC患者,这些患者的临床疾病均为N0。排除了中叶切除术(39 例)和合并-肿瘤(C/T)比值≤0.50(33 例)的患者。我们对350例患者的临床因素、淋巴结转移分布和淋巴结复发模式进行了调查:结果:35 例(10.0%)患者出现淋巴结转移;无一出现 C/T 比值:周围肿瘤较小、C/T 比值较低的 NSCLC 患者的淋巴结转移率较高。
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Extent of Lymph Node Dissection in Patients with Small-Sized Peripheral Non-Small Cell Lung Cancer during Intentional Segmentectomy.

Purpose: Segmentectomy and mediastinal lymph node dissection (MLND) are becoming standard procedures for small-sized (<2 cm) peripheral non-small cell lung cancer (NSCLC). Although the benefits of the less resected lung are proven, the extent of lymph node dissection remains unchanged.

Methods: We studied 422 patients who underwent lobectomy with MLND (lobe specific or systemic) for small peripheral NSCLC with clinical N0 disease. Patients with middle lobectomy (n = 39) and a consolidation-to-tumor (C/T) ratio ≤0.50 (n = 33) were excluded. We investigated the clinical factors, lymph node metastasis distributions, and lymph node recurrence patterns of 350 patients.

Results: Thirty-five (10.0%) patients had lymph node metastasis; none with C/T ratio <0.75 had lymph node metastasis and lymph node recurrence. None had solitary lymph node metastasis in the outside lobe-specific MLND. Six patients had mediastinal lymph node metastasis at the initial site of recurrence; none had mediastinal lymph node recurrence outside the lobe-specific MLND, except for two patients with S6 primary disease.

Conclusion: NSCLC patients with small peripheral tumors and a C/T ratio <0.75 during segmentectomy may not require MLND. The optimal MLND for patients with a C/T ratio ≥0.75, except for those with S6 primary, may be lobe-specific MLND.

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来源期刊
Annals of Thoracic and Cardiovascular Surgery
Annals of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-SURGERY
CiteScore
2.80
自引率
0.00%
发文量
56
审稿时长
4-8 weeks
期刊介绍: Information not localized
期刊最新文献
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