Preoperative Staging in Non-Small Cell Lung Cancer without Lymphadenopathy on Computed Tomogram.
10.4046/trd.1994.41.6.616
- Author:
Seung Ick CHA
;
Chang Ho KIM
;
Jae Yong PARK
;
Tae Hoon JUNG
;
Bong Hyun CHANG
;
Duk Sik KANG
- Publication Type:Original Article
- Keywords:
Non-small cell lung carcinoma;
Preoperative staging
- MeSH:
Adenocarcinoma;
Aorta;
Carcinoma, Large Cell;
Carcinoma, Non-Small-Cell Lung*;
Carcinoma, Squamous Cell;
Humans;
Lymph Nodes;
Lymphatic Diseases*;
Magnetic Resonance Imaging;
Mediastinoscopy;
Neoplasm Metastasis;
Pulmonary Artery;
Thoracic Wall;
Thorax;
Tomography, X-Ray Computed
- From:Tuberculosis and Respiratory Diseases
1994;41(6):616-623
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. METHODS & RESULTS: 1) Records of a total of 41 patients with preoperative T1-3N0M0 non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative T2, 2 cases were identified postoperatively as T3 with invasion of chest wall and among 6 cases with preoperative T1-3, 1 case was identified postoperatively as T4 with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with T1-2, 5 cases wore N1 and 3 cases were N2 postoperatively. After the operation of 6 cases with T3, 2 cases were N1 and 3 cases were N2 postoperatively Preoperative T3 showed more intrathoracic lymph node metastases and higher N2/N1 involvement ratio than preoperative T1-2. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative N2 tumors. CONCLUSION: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative T3 non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.
