Esato K, Sugi K, Kaneda Y, Nawata S
First Department of Surgery, Yamaguchi University of Medicine, Ube, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jan;42(1):8-12.
The effect of mediastinal lymph node dissection on survival rate in clinical N2(-) non-small cell lung cancer patients was assessed. N2(-) was evaluated by both pre-operative computed tomography studies and physical examination during surgery. Systematic mediastinal lymph node dissection, including nodes #1, 2, 3, 3a, 3p, 4, 7, 8 and 9 was performed in 27 patients (T1 or 2, N0 or 1, M0) since 1987 (dissected group). Survival rate and complications were compared with those in 21 patients treated before 1986, in whom mediastinal lymph nodes were not dissected (non-dissected group). 1, 3 and 5 year survival rates in the dissected group were 92.6%, 74.9%, and 74.9%, respectively, which were significantly higher than those in the non-dissected group (71.4%, 61.9% and 41.3%, respectively). Mediastinal lymph node metastases were detected histologically found in three patients, 11% of the dissected group. Respiratory complications showed a significantly higher incidence in the dissected group (p = 0.001). However these complications did not increase the mortality rate in that group. Among elderly patients over 70 years old (8 patients in the dissected group, 7 in the non-dissected group), survival rates were similar in the two groups. In conclusion, systematic mediastinal lymph node dissection significantly improved the survival rate in clinical N2(-) non-small cell lung cancer patients.
评估了纵隔淋巴结清扫术对临床N2（-）非小细胞肺癌患者生存率的影响。通过术前计算机断层扫描研究和手术期间的体格检查对N2（-）进行评估。自1987年起，对27例患者（T1或2，N0或1，M0）进行了系统性纵隔淋巴结清扫，包括第1、2、3、3a、3p、4、7、8和9组淋巴结（清扫组）。将生存率和并发症与1986年前治疗的21例未进行纵隔淋巴结清扫的患者（未清扫组）进行比较。清扫组的1年、3年和5年生存率分别为92.6%、74.9%和74.9%，显著高于未清扫组（分别为71.4%、61.9%和41.3%）。组织学检查发现3例患者有纵隔淋巴结转移，占清扫组的11%。清扫组的呼吸并发症发生率显著更高（p = 0.001）。然而，这些并发症并未增加该组的死亡率。在70岁以上的老年患者中（清扫组8例，未清扫组7例），两组的生存率相似。总之，系统性纵隔淋巴结清扫显著提高了临床N2（-）非小细胞肺癌患者的生存率。
