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J Thorac Cardiovasc Surg 1995;109:403
© 1995 Mosby, Inc.

LETTERS TO THE EDITOR

The location of station 11 pulmonary lymph nodes

Department of Chest Surgery
National Kyushu Cancer Center
3-1-1, Notame, Minami-ku
Fukuoka 815, Japan

Reply to the Editor:

As Dr. Shields pointed out, the words "hilar lymph nodes" are usually applied to the nodes along the main bronchus (No. 10). However, the concept of "hilar" lymph nodes slightly differs among investigators, because the definition of "hilus of the lung" itself is vague. For example, the Japan Lung Cancer Society considered the "hilar" lymph nodes to include main bronchial (No. 10), interlobar (No. 11), and lobar (No. 12) nodes, whereas the "intrapulmonary" lymph nodes include segmental (No. 13) and subsegmental (No. 14) nodes. ¹ Therefore, to describe the location of regional lymph nodes precisely, one should use numbers in the lymph node map of Naruke, Suemasu, and Ishikawa. ^{2 , 3}

The purpose of our study was to clarify whether pathologic N1 disease is a uniformly intermediate group or a mixed group of potentially early-stage disease and advanced-stage disease. There were few reports concerning the significance of N1 level in the postoperative prognosis. We have concentrated our interests on the better survival of patients with pathologic N1 disease involving only lymph nodes within the lobar bronchus (Nos. 12 and 13), which was arbitrarily referred to as "lobar" N1 disease. In contrast to these "lobar" N1 nodes, interlobar lymph nodes (No. 11), especially lying along the intermediate stem bronchus in the right side, were referred to as "hilar" N1 nodes as well as No. 10 lymph nodes. Therefore, we did not claim that interlobar (No. 11) nodes were anatomically included in hilar nodes. We divided pathologic N1 disease into two groups, that is, "lobar" N1 disease (Nos. 12 and 13) and "hilar" disease (Nos. 10 and 11), only to analyze the significance of N1 level in survival. On the basis of on our results, however, the subclassification of N1 nodes, "lobar" and "hilar," might be rationally acceptable regarding postoperative survival.

References

1. The Japan Lung Cancer Society. General rule for clinical and pathological record of lung cancer. 3rd ed. Tokyo: Kanahara & Co., Ltd.,
   
2. Naruke T, Suemasu K, Ishikawa S. Lymph node mapping and curability at various levels of metastasis in resected lung cancer. J THORAC CARDIOVASC SURG 1978;76:832-9.[Abstract]
   
3. UICC. TNM Atlas. 3rd ed., 2nd revision. New York: Springer Verlag, 1992.
   

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yano, T. Search for Related Content PubMed Articles by Yano, T.