HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ara Ketchedjian Hiran C. Fernando Curtis J. Hunter Richard J. Shemin Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ketchedjian, A. Articles by Shemin, R. J. Search for Related Content PubMed PubMed Citation Articles by Ketchedjian, A. Articles by Shemin, R. J. Related Collections Lung - cancer Lung - other

J Thorac Cardiovasc Surg 2006;132:544-548
© 2006 The American Association for Thoracic Surgery

General Thoracic Surgery

Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma

^a Department of Cardiothoracic Surgery, Boston Medical Center, Boston, Mass
^b Georgetown University, School of Medicine, Washington, DC.

Read at the Thirty-first Annual Meeting of the Western Thoracic Surgical Association, Victoria, BC, Canada, June 22-25, 2005.

Received for publication June 27, 2005; revisions received May 16, 2006; accepted for publication May 19, 2006.

^_* Address for reprints: Benedict D. T. Daly, MD, Department of Cardiothoracic Surgery, 88 East Newton St, B402, Boston, MA 02118 (Email: benedict.daly{at}bmc.org).

BACKGROUND: Increasing data implicate histologic grade and radiographic appearance along with tumor size as key prognostic indicators for pulmonary adenocarcinoma. The impact of tumor location on prognosis has not been examined.

METHODS: The records of 530 consecutive patients with pulmonary adenocarcinoma pathologically staged between June 1979 and July 2002 were reviewed. All patients had a preoperative computed tomographic scan of the chest and underwent surgical staging by mediastinoscopy, lymph node sampling, or lymph node dissection. Patients with bronchioalveolar cell carcinoma were excluded. Peripheral tumors were compared with central tumors with regard to stage and survival. A tumor was considered to be central if visualized within the inner third of the lung field or seen bronchoscopically. Patients with T1 cancers were further analyzed on the basis of tumor size. Survival was determined by the Kaplan-Meier analysis and comparisons were made by the log-rank method.

RESULTS: Central tumors were more advanced and demonstrated a significantly (P < .0001) poorer survival than peripheral tumors (median 18 vs 39 months). Sixty percent of patients with central tumors had stage III or stage IV disease compared with 25% of those with peripheral tumors. Central T1 tumors, however, demonstrated a 50% incidence of lymph node involvement. Although the incidence of lymph node metastases increased incrementally with the size of peripheral T1 tumors, it remained 50% for central T1 tumors irrespective of size.

CONCLUSION: Tumor location for pulmonary adenocarcinoma should be considered when planning therapy. Central tumors have a high incidence of lymph node metastases (regardless of size) and a poorer prognosis.

This article has been cited by other articles:

				A. Gomez-Caro, M. Boada, M. Carreno, M. Sanchez, P. Arguis, F. Lomena, J. Ramirez, and L. Molins False-negative rate after positron emission tomography/computer tomography scan for mediastinal staging in cI stage non-small-cell lung cancer Eur J Cardiothorac Surg, January 20, 2012; (2012) ezr272v1. [Abstract] [Full Text] [PDF]

				T. C. Chua, A. Sarkar, A. Saxena, D. Glenn, J. Zhao, and D. L. Morris Long-term outcome of image-guided percutaneous radiofrequency ablation of lung metastases: an open-labeled prospective trial of 148 patients Ann. Onc., October 1, 2010; 21(10): 2017 - 2022. [Abstract] [Full Text] [PDF]

				G. Pelosi, A. Sonzogni, and G. Viale The Classification of Lung Carcinoma: Time to Change the Morphology-Based Approach? International Journal of Surgical Pathology, June 1, 2010; 18(3): 161 - 172. [Abstract] [PDF]

				H. C. Fernando, M. Schuchert, R. Landreneau, and B. T. Daly Approaching the High-Risk Patient: Sublobar Resection, Stereotactic Body Radiation Therapy, or Radiofrequency Ablation Ann. Thorac. Surg., June 1, 2010; 89(6): S2123 - S2127. [Abstract] [Full Text] [PDF]

				A. Gomez-Caro, S. Garcia, N. Reguart, P. Arguis, M. Sanchez, J. M. Gimferrer, R. Marrades, and F. Lomena Incidence of occult mediastinal node involvement in cN0 non-small-cell lung cancer patients after negative uptake of positron emission tomography/computer tomography scan Eur J Cardiothorac Surg, May 1, 2010; 37(5): 1168 - 1174. [Abstract] [Full Text] [PDF]

				N. Wu, C. Lv, S. Yan, H. Duan, Q. Zheng, J. Wang, H. Xiong, and Y. Yang Systemic mediastinal lymph node dissection of right lung cancer: surgical quality control and analysis of mediastinal lymph node metastatic patterns Interact CardioVasc Thorac Surg, April 1, 2008; 7(2): 240 - 243. [Abstract] [Full Text] [PDF]

				J. A. Cesaretti, A. Pennathur, B. S. Rosenstein, S. J. Swanson, and H. C. Fernando Stereotactic Radiosurgery for Thoracic Malignancies Ann. Thorac. Surg., February 1, 2008; 85(2): S785 - S791. [Abstract] [Full Text] [PDF]

				P. C. Lee, J. L. Port, R. J. Korst, Y. Liss, D. N. Meherally, and N. K. Altorki Risk Factors for Occult Mediastinal Metastases in Clinical Stage I Non-Small Cell Lung Cancer Ann. Thorac. Surg., July 1, 2007; 84(1): 177 - 181. [Abstract] [Full Text] [PDF]