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The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 646-653, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
N Martini, BJ Flehinger, F Nagasaki and B Hart
From 1973 to 1981, 75 patients with T1 N1 M0 and T2 N1 M0 disease had a
complete, potentially curative resection with mediastinal lymph node
dissection. Thirty-eight had adenocarcinomas, 36 epidermoid cancer and one
large cell carcinoma. Surgical treatment consisted of lobectomy in 54,
sleeve lobectomy in three, and pneumonectomy in 18. Two patients died
postoperatively. Of 17 patients with T1 N1 disease, 14 had no further
treatment and three received postoperative radiation and/or chemotherapy;
the 5 year cumulative survival rate of these patients was 56%. There were
58 patients with T2 N1 disease. Forty-five had no further treatment and 13
received postoperative radiation and/or chemotherapy; the 5 year cumulative
survival rate of these patients was 48%. The overall incidence of local and
regional recurrence was low, and the brain was the most frequent site of
recurrence. Factors influencing recurrence were histology and proximity of
the tumor to hilum. The specific nodes involved, the number of nodes
affected, and the extent of involvement within the nodes had no observed
effect on survival. There was no observed improvement in survival with the
use of adjuvants. However, survival was significantly poorer in patients
with visceral pleural involvement.
ARTICLES
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