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  • Title: Complete resection via medial sternotomy for non-small cell lung cancer in the right upper lobe.
    Author: Miyamoto H, Wang Z, Fukai R, Futagawa T, Anami Y, Yamazaki A, Morio A, Hata E.
    Journal: ANZ J Surg; 2005 Dec; 75(12):1049-54. PubMed ID: 16398809.
    Abstract:
    BACKGROUND: Right upper lobectomy with right cervical and bilateral mediastinal lymph node dissection via a median approach was performed for non-small cell lung cancer. METHODS: From 1995 to 2003, 48 patients aged < or = 70 years underwent resection of cancer in the right upper lobe, including 26 with N0, four with N1 and 18 with N2 disease. RESULTS: Metastases to the right cervical, highest mediastinal, pretracheal and bilateral tracheobronchial lymph nodes were frequent. There were no operative or hospital deaths. Preoperative accuracy of N-factor diagnosis was only 35.4%. The overall 5-year survival rate was 58.8%. The rate for C-N2 disease (n = 18) was 42.6%, and the rate for p-N2 disease (n = 7) and p-N3 disease (n = 13) was 57.1% and 0%, respectively, using the Kaplan-Meier method. CONCLUSIONS: Patients without N3 disease have a good prognosis, and extended and systematic radical lymphadenectomy via median sternotomy improves the staging, and possibly the prognosis of pure N2 disease.
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