Radical Pneumonectomy

Cahan, William G.; Watson, William L.; Pool, John L.

doi:10.1016/s0096-5588(20)31234-4

Cited by 96 publications

(17 citation statements)

References 6 publications

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“…Initial standards of care for curative intent surgery for lung cancer mandated complete mediastinal lymph node dissection. 15 A subsequent review in 1995 showed favorable long-term survival for patients who underwent complete lymph node dissection, 16 the underlying notion being that rate of recurrence and long-term survival could be potentially improved by removing occult metastatic disease. This mandate was tempered by ACOSOG Z0030, which showed no additional survival benefit for patients who underwent systematic lymph node dissection compared with those who had mediastinal lymph node sampling, as long as the extensive systematic lymph node sampling mandated by the trial was adequately performed.…”

Section: Discussionmentioning

confidence: 99%

Effect of the number of lymph nodes examined on the survival of patients with stage I non–small cell lung cancer who undergo sublobar resection

Yendamuri

Dhillon

Groman

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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Many patients having sublobar resection for early stage NSCLC in the United States do not have a single lymph node removed for pathologic examination. The number of LNE is associated with improved survival, presumably due to avoidance of mis-staging. This association seems greater than the association with extent of resection (segmentectomy vs wedge resection). Appropriate lymph node examination remains an important part of resection for lung cancer even if the resection is sublobar.

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Section: Discussionmentioning

confidence: 99%

Effect of the number of lymph nodes examined on the survival of patients with stage I non–small cell lung cancer who undergo sublobar resection

Yendamuri

Dhillon

Groman

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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“…The benefit of that first pneumonectomy established the removal of the whole lung as the standard operation for the surgical treatment of lung cancer. In fact, in 1951, when Cahan et al systematized lung resection with lymphadenectomy, they described the removal of the whole lung, which they called radical pneumonectomy, to differentiate it from simple pneumonectomy, that is, without lymphadenectomy [ 3 ]. Interestingly, nine years later, in 1960, Cahan described radical lobectomy—the removal of a lobe with specific lymphadenectomy depending on the lobar location of the primary tumor—and stated that radical lobectomy should be reserved for those patients who could not undergo radical pneumonectomy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Cahan et al established it as one of the principles of the surgical treatment of lung cancer, among the absence of distant metastases, a reasonable low morbidity and mortality and the absence of other effective therapy. Knowing from experience that the lymph nodes could be involved at the time of resection or in the future, they wrote the following: “If these lymphatic areas are not resected at the time of the original procedure, they would be hidden within the body so that their future involvement by metastases would escape early detection” [ 3 ]. Since then, an adequate intrathoracic lymph node assessment has been an important element in all definitions of complete resection.…”

Section: Introductionmentioning

confidence: 99%

The Evolving Concept of Complete Resection in Lung Cancer Surgery

Rami–Porta

2021

Cancers

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Different definitions of complete resection were formulated to complement the residual tumor (R) descriptor proposed by the American Joint Committee on Cancer in 1977. The definitions went beyond resection margins to include the status of the visceral pleura, the most distant nodes and the nodal capsule and the performance of a complete mediastinal lymphadenectomy. In 2005, the International Association for the Study of Lung Cancer (IASLC) proposed definitions for complete, incomplete and uncertain resections for international implementation. Central to the IASLC definition of complete resection is an adequate nodal evaluation either by systematic nodal dissection or lobe-specific systematic nodal dissection, as well as the integrity of the highest mediastinal node, the nodal capsule and the resection margins. When there is evidence of cancer remaining after treatment, the resection is incomplete, and when all margins are free of tumor, but the conditions for complete resection are not fulfilled, the resection is defined as uncertain. The prognostic relevance of the definitions has been validated by four studies. The definitions can be improved in the future by considering the cells spread through air spaces, the residual tumor cells, DNA or RNA in the blood, and the determination of the adequate margins and lymphadenectomy in sublobar resections.

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“…Mediastinal and hilar lymph node dissection has been a core component of lung cancer surgery since Cahan reported the first series of pulmonary lobectomies with regional lymph node dissection [ 1 ]. In 1996, the International Association for the Study of Lung Cancer (IASLC) accepted systematic nodal dissection (SND) as an integral feature of intra-thoracic cancer surgery [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Immune response after systematic lymph node dissection in lung cancer surgery: changes of interleukin-6 level in serum, pleural lavage fluid, and lung supernatant in a dog model

et al. 2013

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BackgroundSystematic nodal dissection (SND) is regarded as a core component of lung cancer surgery. However, there has been a concern on the increased morbidity associated with SND. This study was performed to investigate whether or not SND induces significant immune response.MethodsSixteen dogs were divided into two groups; group 1 (n = 8) underwent thoracotomy only, and group 2 (n = 8) underwent SND after thoracotomy. We compared interleukin-6 (IL-6) levels in serum, pleural lavage fluid and lung supernatant at the time of thoracotomy (T0) and at 2 h(T1) after thoracotomy (group 1) or SND (group 2). Severity of inflammation and IL-6 expression in lung tissue were evaluated in a semi-quantitative manner.ResultsThe operative results were comparable. IL-6 was not detected in serum in either group. IL-6 in pleural lavage fluid marginally increased from 4.75 ± 3.74 pg/mL at T0 to 19.75 ± 8.67 pg/mL at T1 in group 1 (P = 0.112), and from 7.75 ± 5.35 pg/mL to 17.72 ± 8.58 pg/mL in group 2 (P = 0.068). IL-6 in lung supernatant increased from 0.36 ± 0.14 pg/mL/mg to 1.15 ± 0.17 pg/mL/mg in group 1 (P = 0.003), and from 0.25 ± 0.08 pg/mL/mg to 0.82 ± 0.17 pg/mL/mg in group 2 (P = 0.001). However, the degree of increase in IL-6 in pleural lavage fluid and lung supernatant were not different between two groups (P = 0.421 and P = 0.448). There was no difference in severity of inflammation and IL-6 expression between groups.ConclusionsSND did not increase IL-6 in pleural lavage fluid and lung supernatant. This result suggests that SND could be routinely performed in lung cancer surgery without increasing the significant inflammatory response.

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Radical Pneumonectomy

Cited by 96 publications

References 6 publications

Effect of the number of lymph nodes examined on the survival of patients with stage I non–small cell lung cancer who undergo sublobar resection

Effect of the number of lymph nodes examined on the survival of patients with stage I non–small cell lung cancer who undergo sublobar resection

The Evolving Concept of Complete Resection in Lung Cancer Surgery

Immune response after systematic lymph node dissection in lung cancer surgery: changes of interleukin-6 level in serum, pleural lavage fluid, and lung supernatant in a dog model

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