Mediastinal lymph node dissection in left lung cancer
Morishita, K.; Kusajima, K.; Tanaka, H.; Kuroki, M.; Komatsu, S.
Kyobu Geka. Japanese Journal of Thoracic Surgery 47(1): 24-27
1994
ISSN/ISBN: 0021-5252 PMID: 8277627 Document Number: 423487
It is usually impossible to perform a complete systemic mediastinal lymph node dissection in left-side pulmonary carcinomas because the aortic arch gets in the way. The purpose of this study was to determine if incomplete lymph node dissection influences late mortality. We retrospectively analyzed 222 patients who had complete resection of non-small-cell lung cancer, 141 on the right lung and 81 on the left lung. There were 155 men and 67 women. They ranged in age from 35 to 78 years. 146 patients were in Stage I, 41, in the Stage II and 35, in the Stage III A, except for T3 diseases. The 5-year survival rates of left lung cancer were 82% and 35% in the Stage I group and the Stage II group, respectively. There was no difference when compared with the corresponding groups with right lung cancers. The 3-year survival, however, was 0% in the Stage III A group with left lung cancer excluding T3 diseases; this was significantly lower than that of right lung cancer (p < 0.01). The results recommend extended mediastinal lymph node dissection on the left-side squamous cell carcinoma to improve the survival of patients with left-side N2 diseases, when the tracheobronchial lymph nodes are involved.