Thorac Cardiovasc Surg 2008; 56(3): 162-166
DOI: 10.1055/s-2007-989368
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Thoracoscopic Lobectomy with Systemic Lymph Node Dissection for Lymph Node Positive Non-Small Cell Lung Cancer - Is Thoracoscopic Lymph Node Dissection Feasible?

T. Shiraishi1 , M. Hiratsuka1 , Y. Yoshinaga1 , S. Yamamoto1 , A. Iwasaki1 , T. Shirakusa1
  • 1Department of Surgery II, Fukuoka University School of Medicine, Fukuoka, Japan
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Publikationsverlauf

received January 23, 2007

Publikationsdatum:
26. März 2008 (online)

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Abstract

Introduction: The impact of thoracoscopic systemic lymph node dissection (LND) on loco-regional control of non-small cell lung cancer (NSCLC) with positive lymph node metastasis was investigated. Patients and Methods: Thoracoscopic lobectomy with systemic LND was performed for clinical stage I NSCLC. 340 patients were admitted for either a thoracoscopic (n = 98) or a standard open (n = 242) lobectomy with systemic LND. Of those 340 cases, 75 cases (20 thoracoscopic and 55 open) were pathologically diagnosed with node-positive disease. A retrospective chart review of these 75 cases was performed. Results: No significant difference in the overall or loco-regional recurrence-free survival was observed between the groups. The results of a multivariate analysis of the overall and the loco-regional recurrence-free survival demonstrated that the significant factors were tumor size for overall recurrence-free survival, and sex and surgical procedure (use of thoracoscopic surgery) for loco-regional recurrence-free survival, respectively. Conclusion: In general, thoracoscopic lobectomy for c-stage I disease may have no survival disadvantage over open procedures. It might, however, increase the risk of local recurrence when used to treat pathologically node-positive disease. Caution should be used when treating those cases with thoracoscopic surgery.

References

Dr. MD, PhD Takeshi Shiraishi

Department of Surgery II
Fukuoka University School of Medicine

7-45-1 Nanakuma, Jonan-ku, Fukuoka City

814-0180 Fukuoka

Japan

Telefon: + 81 9 28 01 10 11

Fax: + 81 9 28 61 82 71

eMail: tshiraishi-ths@umin.ac.jp