Lobe-Specific Lymph Node Dissection for Clinical Early-Stage (cIA) Peripheral Non-small Cell Lung Cancer Patients: What and How?

Abstract:

OBJECTIVE:We investigated the possible lobe-specific lymph node (LN) metastasis pattern of early-stage peripheral non-small cell lung cancers (NSCLC) and define the extent of lobe-specific LN dissection for them. METHODS:We retrospectively collected clinical data of patients undergoing lobectomy or segmentectomy with systematic lymphadenectomy for clinical T1N0M0 peripheral NSCLC from January 2015 to December 2018. The LN metastasis pattern was analyzed by tumor lobe location. RESULTS:A total of 590 patients were included for analysis. The mean number of total dissected LNs was 12.3 ± 5.8 and 8.2 ± 4.1 for total dissected mediastinal LNs. The rate of mediastinal LN metastasis was 9.5%. For cases of upper lobe tumor and lower lobe tumor, 8.8% and 6.0% of them respectively metastasized to the upper LN zone (P = 0.274). However, upper lobe tumors hardly metastasized to the subcarinal (0.3%) and lower (0.3%) LN zones while for lower lobe tumors, the rate of LN metastasis was 10.2% and 5.4% respectively (both P < 0.001). However, all cases (100%) metastasizing from lower lobes to the upper LN zone had a tumor size of 2-3 cm, whereas cases with a tumor size ≤ 2 cm had no metastasis (0%). None of the tumors in the right middle lobe metastasized to the lower LN zone (0%). CONCLUSIONS:A lobe-specific LN metastasis pattern was observed in clinical stage IA peripheral NSCLC. For tumors in upper lobes (≤ 3 cm), there may be no need to dissect lower mediastinal LNs and for tumors in lower lobes (≤ 2 cm), dissecting upper mediastinal LNs may not be required.

journal_name

Ann Surg Oncol

authors

Deng HY,Zhou J,Wang RL,Jiang R,Zhu DX,Tang XJ,Zhou Q

doi

10.1245/s10434-019-07926-3

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

472-480

issue

2

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-019-07926-3

journal_volume

27

pub_type

杂志文章
  • Tumor Involvement of the Nipple in Total Skin-Sparing Mastectomy: Strategies for Management.

    abstract:BACKGROUND:Despite a growing body of literature on oncologic and reconstructive outcomes after total skin-sparing mastectomy (TSSM), some questions related to this approach remain unanswered, including strategies for managing tumor involvement of the nipple while maintaining the aesthetic benefits of TSSM. METHODS:A p...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-015-4646-5

    authors: Amara D,Peled AW,Wang F,Ewing CA,Alvarado M,Esserman LJ

    更新日期:2015-11-01 00:00:00

  • Lymph node counts and ratio in axillary dissections following neoadjuvant chemotherapy for breast cancer: a better alternative to traditional pN staging.

    abstract:BACKGROUND:Neoadjuvant chemotherapy (NCT) for breast cancer might change the number of involved and detected nodes in axillary lymph node dissections (ALND). In this study, we analyzed whether the number of dissected nodes and the lymph node ratio (LNR, defined as the proportion of involved nodes in dissected nodes) wo...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-013-3245-6

    authors: Chen S,Liu Y,Huang L,Chen CM,Wu J,Shao ZM

    更新日期:2014-01-01 00:00:00

  • Breast cancer survival according to number of nodes removed.

    abstract:BACKGROUND:Results from randomized trials indicate a 5.4% survival advantage associated with axillary dissection. To gain insight on survival outcomes when less than an axillary dissection is performed, we performed a retrospective analysis to determine survival outcome for node-negative and node-positive breast cancer...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/aso.2003.03.073

    authors: Krag DN,Single RM

    更新日期:2003-12-01 00:00:00

  • Toward better soft tissue sarcoma staging: building on american joint committee on cancer staging systems versions 6 and 7.

    abstract:BACKGROUND:Based on review of patient data in case conferences over time, we hypothesized that clinically relevant data are omitted in routine soft tissue sarcoma staging. METHODS:We examined subsets of a prospectively collected single institution soft tissue sarcoma database with respect to criteria of the AJCC versi...

    journal_title:Annals of surgical oncology

    pub_type: 临床试验,杂志文章

    doi:10.1245/s10434-013-3052-0

    authors: Maki RG,Moraco N,Antonescu CR,Hameed M,Pinkhasik A,Singer S,Brennan MF

    更新日期:2013-10-01 00:00:00

  • The utility of frozen section evaluation for follicular thyroid lesions.

    abstract:BACKGROUND:Because fine-needle aspiration cannot reliably discriminate between benign and malignant follicular thyroid lesions, some surgeons use intraoperative frozen section (FS) to guide operative management. To determine the utility of FS for these lesions, we reviewed our institutional experience. METHODS:Between...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1007/BF02524352

    authors: Callcut RA,Selvaggi SM,Mack E,Ozgul O,Warner T,Chen H

    更新日期:2004-01-01 00:00:00

  • The lymphatic anatomy of the breast and its implications for sentinel lymph node biopsy: a human cadaver study.

    abstract:BACKGROUND:Current understanding of the lymphatic system of the breast is derived mainly from the work of the anatomist Sappey in the 1850s, with many observations made during the development and introduction of breast lymphatic mapping and sentinel node biopsy contributing to our knowledge. METHODS:Twenty four breast...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-007-9709-9

    authors: Suami H,Pan WR,Mann GB,Taylor GI

    更新日期:2008-03-01 00:00:00

  • Risk Factors for Positive Deep Pelvic Nodal Involvement in Patients with Palpable Groin Melanoma Metastases: Can the Extent of Surgery be Safely Minimized? : A Retrospective, Multicenter Cohort Study.

    abstract:BACKGROUND:Patients with palpable melanoma groin metastases have a poor prognosis. There is debate whether a combined superficial and deep groin dissection (CGD) is necessary or if superficial groin dissection (SGD) alone is sufficient. AIM:The aim of this study was to analyze risk factors for deep pelvic nodal involv...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1245/s10434-015-4602-4

    authors: Oude Ophuis CM,van Akkooi AC,Hoekstra HJ,Bonenkamp JJ,van Wissen J,Niebling MG,de Wilt JH,van der Hiel B,van de Wiel B,Koljenović S,Grünhagen DJ,Verhoef C

    更新日期:2015-12-01 00:00:00

  • Comparison of Tissue and Blood Concentrations of Oxaliplatin Administrated by Different Modalities of Intraperitoneal Chemotherapy.

    abstract:BACKGROUND:Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new technology for delivering intraperitoneal chemotherapy. It is generally assumed that with PIPAC, the ratio of peritoneal to systemic drug concentration is superior to liquid hyperthermic intraperitoneal chemotherapy (HIPEC). To date, no direct...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-019-07695-z

    authors: Giger-Pabst U,Bucur P,Roger S,Falkenstein TA,Tabchouri N,Le Pape A,Lerondel S,Demtröder C,Salamé E,Ouaissi M

    更新日期:2019-12-01 00:00:00

  • Cranial irradiation after surgical excision of brain metastases in melanoma patients.

    abstract:BACKGROUND:Brain metastases account for 20-54% of reported deaths from melanoma. Duration and quality of survival depend on the extent of metastatic disease and response to treatment. Treatment goals are palliation of symptoms and prolongation of life. No studies have directly compared surgery alone and surgery with ad...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1007/BF02305789

    authors: Skibber JM,Soong SJ,Austin L,Balch CM,Sawaya RE

    更新日期:1996-03-01 00:00:00

  • A Comparison of the LigaSure and harmonic scalpel in thyroid surgery: a single institution review.

    abstract:BACKGROUND:During the last few years, many surgeons have begun to utilize the LigaSure device or Harmonic scalpel to perform thyroid surgery. Several papers have demonstrated the benefits of these devices compared with traditional hand-tying techniques. The purpose of this study was to examine our institution's experie...

    journal_title:Annals of surgical oncology

    pub_type: 临床试验,杂志文章

    doi:10.1245/s10434-010-1334-3

    authors: Zarebczan B,Mohanty D,Chen H

    更新日期:2011-01-01 00:00:00

  • Minimally Invasive Approaches in Locally Advanced Cervical Cancer Patients Undergoing Radical Surgery After Chemoradiotherapy: A Propensity Score Analysis.

    abstract:PURPOSE:Chemoradiation (CT/RT) followed by radical surgery (RS) may play a role in locally advanced cervical cancer (LACC) patients with suboptimal response to CT/RT or in low-income countries with limited access to radiotherapy. Our aim is to evaluate oncological and surgical outcomes of minimally invasive radical sur...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-020-09302-y

    authors: Ferrandina G,Gallotta V,Federico A,Fanfani F,Ercoli A,Chiantera V,Cosentino F,Turco LC,Legge F,Anchora LP,Bizzarri N,Moroni R,Macchia G,Valentini V,Scambia G

    更新日期:2020-11-09 00:00:00

  • The Landmark Series: Neuroendocrine Tumor Liver Metastases.

    abstract:BACKGROUND:Neuroendocrine tumors are becoming increasingly prevalent, with many patients presenting with or developing metastatic disease to the liver. METHODS:In this landmark series paper, we highlight the critical studies that have defined the surgical management of neuroendocrine tumor liver metastases, as well as...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,评审

    doi:10.1245/s10434-020-08787-x

    authors: Gangi A,Howe JR

    更新日期:2020-09-01 00:00:00

  • Efficacy of Talimogene Laherparepvec (T-VEC) Therapy in Patients with In-Transit Melanoma Metastasis Decreases with Increasing Lesion Size.

    abstract:BACKGROUND:Talimogene laherparepvec (T-VEC) is the first injectable oncolytic viral therapy approved for in-transit melanoma metastasis, with a reported overall response rate (ORR) of 25% and complete response rate (CRR) of 10%. To ascertain the role of patient selection on outcomes in routine practice, we evaluated th...

    journal_title:Annals of surgical oncology

    pub_type: 临床试验,杂志文章

    doi:10.1245/s10434-019-07691-3

    authors: Masoud SJ,Hu JB,Beasley GM,Stewart JH 4th,Mosca PJ

    更新日期:2019-12-01 00:00:00

  • Comparison of Long-Term Outcomes After Non-curative Endoscopic Resection in Older Patients with Early Gastric Cancer.

    abstract:BACKGROUND:Limited data exist that describe the long-term outcomes from additional surgery following non-curative endoscopic resection (ER) of early gastric cancer (EGC) in older people. This study aimed to determine the appropriate treatment strategy for these patients. METHODS:We analyzed data from 2895 patients who...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-017-5888-1

    authors: Pyo JH,Lee H,Min BH,Lee JH,Kim KM,Yoo H,Ahn S,An JY,Choi MG,Lee JH,Sohn TS,Bae JM,Kim JJ,Kim S

    更新日期:2017-09-01 00:00:00

  • Novel Prognostic Models Predicting the Cancer-Specific Survival in Patients with Cutaneous Melanoma Based on Metastatic Lymph Node Status.

    abstract:BACKGROUND:In cutaneous melanoma (CM), the present methods of lymph node (LN) staging have not sufficiently utilized the prognostic information of metastatic LNs. In this study, we aimed to construct prognostic nomograms based on the number of positive LNs (PLNs) and other clinicopathologic characteristics of CM patien...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-020-09556-6

    authors: Li W,Xu X,Zhang Y

    更新日期:2021-01-11 00:00:00

  • 8q24 Polymorphisms and Diabetes Mellitus Regulate Apolipoprotein A-IV in Colorectal Carcinogenesis.

    abstract:BACKGROUND:Here, we explored the genetic interactions between diabetes and oncogenic single-nucleotide polymorphisms (SNPs) that determine colorectal cancer (CRC) morbidity. METHODS:8q24 rs6983267 polymorphism analysis and cDNA microarray were performed in 107 CRCs to identify the genes associated with diabetes and th...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-016-5374-1

    authors: Sugimachi K,Yamaguchi R,Eguchi H,Ueda M,Niida A,Sakimura S,Hirata H,Uchi R,Shinden Y,Iguchi T,Morita K,Yamamoto K,Miyano S,Mori M,Maehara Y,Mimori K

    更新日期:2016-08-01 00:00:00

  • Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy.

    abstract:BACKGROUND:Laparoscopic liver resection for perihilar cholangiocarcinoma (pCCA) is still in its infancy. The biliary-enteric reconstruction represents one of the most delicate parts of this minimally invasive procedure. METHODS:In this study, a 78-year old woman with perihilar cholangiocarcinoma (pCCA) type 3b underwe...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-020-09175-1

    authors: Sucher R,Scheuermann U,Seehofer D

    更新日期:2020-09-30 00:00:00

  • Prognostic value of cytokeratin-positive bone marrow cells of gastric cancer patients.

    abstract:BACKGROUND:Epithelial cells in the bone marrow of patients with gastric cancer suggest tumor dissemination; however, their prognostic implications are controversial. We prospectively evaluated the correlation of bone marrow findings, recurrence rate, and disease-free survival after long-term follow-up. METHODS:Bone ma...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-006-9039-3

    authors: Gretschel S,Schick C,Schneider U,Estevez-Schwarz L,Bembenek A,Schlag PM

    更新日期:2007-02-01 00:00:00

  • The Ethics of Breast Surgery.

    abstract::Breast surgery has evolved as a subspecialty of general surgery and requires a working knowledge of benign and malignant diseases, surgical techniques, shared decision-making with patients, collaboration with a multi-disciplinary team, and a basic foundation in surgical ethics. Ethics is defined as the practice of ana...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,评审

    doi:10.1245/s10434-015-4751-5

    authors: Throckmorton A,VanderWalde L,Brackett C,Dominici L,Eisenhauer T,Johnson N,Kong A,Ludwig K,O'Neill J,Pugliese M,Teller P,Sarantou T

    更新日期:2015-10-01 00:00:00

  • Increasing Appropriate BRCA1/2 Mutation Testing: The Role of Family History Documentation and Genetic Counseling in a Multidisciplinary Clinic.

    abstract:BACKGROUND:Findings show that 5-10 % of women with a diagnosis of breast cancer (BCa) have actionable genetic mutations. The National Comprehensive Cancer Network guidelines for testing to detect BRCA1/2 mutations include personal history (PH) variables such as age of 45 years or younger and a family history (FH) varia...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-016-5545-0

    authors: Kishan AU,Gomez CL,Dawson NA,Dvorak R,Foster NM,Hoyt A,Hurvitz SA,Kusske A,Silver EL,Tseng C,McCloskey SA

    更新日期:2016-12-01 00:00:00

  • Predicting the Value of Adjuvant Therapy in Esophageal Squamous Cell Carcinoma by Combining the Total Number of Examined Lymph Nodes with the Positive Lymph Node Ratio.

    abstract:BACKGROUND:The value of adjuvant therapy for esophageal squamous cell carcinoma (ESCC) has been controversial, at least partially due to the lack of efficient criteria for selecting suitable patients. This study aimed to explore the existence of parameters related to lymph node (LN) status that can predict the value of...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-019-07489-3

    authors: Li Y,Zhao W,Ni J,Zou L,Yang X,Yu W,Fu X,Zhao K,Zhang Y,Chen H,Xiang J,Xie C,Zhu Z

    更新日期:2019-08-01 00:00:00

  • FANCD2 mRNA overexpression is a bona fide indicator of lymph node metastasis in human colorectal cancer.

    abstract:BACKGROUND:Lymph node metastasis is widely accepted as one of the most important determinants of prognosis in colorectal cancer (CRC) patients. Therefore, there is an urgent need to identify molecular markers that can be used to predict lymph node metastasis. MATERIALS AND METHODS:Candidate genes were found using LMD ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-010-1002-7

    authors: Ozawa H,Iwatsuki M,Mimori K,Sato T,Johansson F,Toh H,Watanabe M,Mori M

    更新日期:2010-09-01 00:00:00

  • Long-term outcomes for older patients with papillary thyroid carcinoma: should another age cutoff beyond 45 years be added?

    abstract:BACKGROUND:Although an age cutoff of 45 years has often been adopted to stratify cancer risk in papillary thyroid carcinoma (PTC), both cancer-specific survival (CSS) and disease-specific survival (DFS) continue to worsen beyond this cutoff. This study aimed to determine whether advanced age (i.e., >60 years) at diagno...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-014-4055-1

    authors: Lang BH,Lo CY,Wong KP,Wan KY

    更新日期:2015-02-01 00:00:00

  • Cure model survival analysis after hepatic resection for colorectal liver metastases.

    abstract:BACKGROUND:Statistical cure is achieved when a patient population has the same mortality as cancer-free individuals; however, data regarding the probability of cure after hepatectomy of colorectal liver metastases (CLM) have never been provided. We aimed to assess the probability of being statistically cured from CLM b...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-014-4234-0

    authors: Cucchetti A,Ferrero A,Cescon M,Donadon M,Russolillo N,Ercolani G,Stacchini G,Mazzotti F,Torzilli G,Pinna AD

    更新日期:2015-01-01 00:00:00

  • Ethical Considerations of Medical Photography in the Management of Breast Disease.

    abstract:BACKGROUND:Medical photography has become an important component of the evaluation and management of patients across many specialties. It is increasingly utilized in contemporary practice with modern smartphones and enhanced digital media. Photography can enhance and improve treatment plans and communication between pr...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,评审

    doi:10.1245/s10434-018-6603-6

    authors: Nguyen TT,VanderWalde L,Bellavance E,Eisenhauer T,Hieken T,Johnson N,Kaufman DI,O'Neill J,Patten CR,Teller P,Tevis S,Sarantou T,Throckmorton A

    更新日期:2018-10-01 00:00:00

  • Troubleshooting Sentinel Lymph Node Biopsy in Breast Cancer Surgery.

    abstract:BACKGROUND:Performing a sentinel lymph node biopsy (SLNB) is the standard of care for axillary nodal staging in patients with invasive breast cancer and clinically negative nodes. The procedure provides valuable staging information with few complications when performed by experienced surgeons. However, variation in pro...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-016-5432-8

    authors: James TA,Coffman AR,Chagpar AB,Boughey JC,Klimberg VS,Morrow M,Giuliano AE,Harlow SP

    更新日期:2016-10-01 00:00:00

  • Effect of breast surgery on serum levels of insulin-like growth factors (IGF-I, IGF-II, and IGF binding protein-3) in women with benign and malignant breast lesions.

    abstract:BACKGROUND:There is evidence that insulin-like growth factors play a role in the development of breast cancer. Antiestrogens reduce circulating levels of IGF-I, but the influence of other breast cancer treatments, including surgery, is unknown and is investigated in this study. METHODS:Circulating serum concentrations...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1007/s10434-001-0025-5

    authors: Holdaway IM,Lethaby AE,Mason BH,Singh V,Harman JE,MacCormick M,Civil ID

    更新日期:2001-01-01 00:00:00

  • Percutaneous Preoperative Biliary Drainage for Resectable Perihilar Cholangiocarcinoma: No Association with Survival and No Increase in Seeding Metastases.

    abstract:BACKGROUND:Endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) are both used to resolve jaundice before surgery for perihilar cholangiocarcinoma (PHC). PTBD has been associated with seeding metastases. The aim of this study was to compare overall survival (OS) and the incidence of in...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-015-4676-z

    authors: Wiggers JK,Groot Koerkamp B,Coelen RJ,Doussot A,van Dieren S,Rauws EA,Schattner MA,van Lienden KP,Brown KT,Besselink MG,van Tienhoven G,Allen PJ,Busch OR,D'Angelica MI,DeMatteo RP,Gouma DJ,Kingham TP,Verheij J,Jarnagi

    更新日期:2015-12-01 00:00:00

  • Mucinous rectal cancer: effectiveness of preoperative chemoradiotherapy and prognosis.

    abstract:BACKGROUND:This study investigated the effects of preoperative chemoradiotherapy (PCRT) and the prognoses of patients with mucinous rectal cancer compared with those with nonmucinous cancer. METHODS:We retrospectively reviewed the medical records of 368 patients who underwent curative resection after PCRT, between 200...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-011-1612-8

    authors: Shin US,Yu CS,Kim JH,Kim TW,Lim SB,Yoon SN,Yoon YS,Kim CW,Kim JC

    更新日期:2011-08-01 00:00:00

  • Perioperative use of beta-blockers and COX-2 inhibitors may improve immune competence and reduce the risk of tumor metastasis.

    abstract:BACKGROUND:COX inhibitors and beta-blockers were recently suggested to reduce cancer progression through inhibition of tumor proliferation and growth factor secretion, induction of tumor apoptosis, and prevention of cellular immune suppression during the critical perioperative period. Here we evaluated the perioperativ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-008-9890-5

    authors: Benish M,Bartal I,Goldfarb Y,Levi B,Avraham R,Raz A,Ben-Eliyahu S

    更新日期:2008-07-01 00:00:00