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The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 504-512, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
J Deslauriers, J Brisson, R Cartier, M Fournier, D Gagnon, M Piraux and M Beaulieu
Satellite nodules are considered to be predictive of poor prognosis in
breast cancer and in melanoma. In lung cancer, there is no information as
to their definition, prevalence, or implication as a prognosis factor of
survival after resection. Over the past 18 years (1969 to 1987), 84
patients underwent pulmonary resection for primary lung cancer accompanied
by satellite nodules. These nodules were defined as well-circumscribed
accessory carcinoma foci clearly separated from the main tumor but with
identical histologic characteristics. All were smaller than the primary
carcinoma and most were located within the same lobe. Survival rates of
patients with satellite nodules were compared to those of 1021 patients
without satellite nodules who underwent resection during the same time
interval. The 1-, 3-, and 5- year survival rates for all patients
classified as having no satellite nodules were 78%, 54%, and 44%,
respectively, and the median survival for the entire group was 30 months.
In patients with satellite nodules, these survival rates were 60.9%, 32.7%,
and 21.6%, respectively, with a median survival of 15 months. The
deleterious effect of satellite nodules was more significant in patients
with stage I disease (p = 0.0008) than in patients with stage II (p =
0.0354) or stage III (p = 0.0145) disease. Survival data obtained by
comparison of satellite nodule status and histologic characteristics shows
that 5-year survival figures are better for patients with no satellite
nodules in both the squamous and the nonsquamous groups. This study
demonstrates that satellite nodules associated with lung cancer are
indicative of locally advanced and/or premetastatic disease. These patients
should be included in the stage group IIIa of the TNM stage grouping
classification.
ARTICLES
Carcinoma of the lung. Evaluation of satellite nodules as a factor influencing prognosis after resection
Centre de Pneumologie, Hopital Laval, Ste-Foy, Quebec, Canada.
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