Significance of positive superior mediastinal nodes identified at mediastinoscopy in patients with resectable cancer of the lung

Pearson, F.G.; Delarue, Norman C.; lives, R.; Todd, Thomas R.J.; Cooper, Joel D.

doi:10.1016/s0022-5223(19)37318-0

Cited by 367 publications

(60 citation statements)

References 9 publications

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“…This study concluded that there was no justification for doing anything different for younger patients with lung cancer, except that aggressive local resection in the absence of lymph node metastases was indicated. Moreover, evolving surgical opinion in adults suggests that patients with both squamous and adenocarcinoma of the lung and ipsilateral mediastinal metastases detected at thoracotomy may benefit from excision of the tumor and all accessible mediastinal lymph nodes when treated with postoperative irradiation [ 8,9]. Encouraging results in adults suggests that this approach might also be applicable and benefit selected pediatric patients with lung cancer.…”

Section: Case Reportmentioning

confidence: 99%

Lung cancer in childhood

Epstein¹,

Aronchick²

1989

Med. Pediatr. Oncol.

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A 16-year-old boy had unresolving right lower lobe consolidation due to primary adenocarcinoma of the lung. Lung cancer is rare in children, is usually adenocarcinoma or undifferentiated histology, and frequently presents with advanced disease. It may be confused with atelectasis attributable to a foreign body or bronchial adenoma, plasma cell granuloma, pulmonary sequestration, or chronic infection. We review the clinical features of pediatric lung cancer and differences in lung cancer between children and adults.

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Section: Case Reportmentioning

confidence: 99%

Lung cancer in childhood

Epstein¹,

Aronchick²

1989

Med. Pediatr. Oncol.

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“…1 Historical series from experienced centers document dismal survival (7-16% at five years) for patients with clinically obvious N2 NSCLC treated with primary surgery. [2][3][4][5] The five-year survival ranges from 5% to 8% in patients with bulky N2 disease to nearly 35% in patients with single station, microscopic N2 disease. 6 Neoadjuvant (preoperative) therapy for operable NSCLC has been the subject of a large number of studies, but in spite of the progress evidenced by well designed and well conducted phase III randomized trials and meta-analyses, many issues remain unsolved, especially in locally advanced IIIA stage.…”

Section: Introductionmentioning

confidence: 99%

Comparison of mediastinal lymph node status and relapse pattern in clinical stage IIIA non‐small cell lung cancer patients treated with neoadjuvant chemotherapy versus upfront surgery: A single center experience

et al. 2017

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BackgroundIn spite of the progress made in neoadjuvant therapy for operable non small‐cell lung cancer (NSCLC), many issues remain unsolved, especially in locally advanced stage IIIA.MethodsRetrospective data of 163 patients diagnosed with stage IIIA NSCLC after surgery was analyzed. The patients were divided into two groups: a preoperative chemotherapy group including 59 patients who received platinum‐etoposide doublet treatment before surgery, and an upfront surgery group including 104 patients for whom surgical resection was the first treatment step. Adjuvant chemotherapy or/and radiotherapy was administered to 139 patients (85.3%), while 24 patients (14.7%) were followed‐up only.ResultsThe rate of N2 disease was significantly higher in the upfront surgery group (P < 0.001). The one‐year relapse rate was 49.5% in the preoperative chemotherapy group compared to 65.4% in the upfront surgery group. There was a significant difference in relapse rate in relation to adjuvant chemotheraphy treatment (P = 0.007). The probability of relapse was equal whether radiotherapy was applied or not (P = 0.142). There was no statistically significant difference in two‐year mortality (P = 0.577). The median survival duration after two years of follow‐up was 19.6 months in the preoperative chemotherapy group versus 18.8 months in the upfront surgery group (P = 0.608 > 0.05).ConclusionThere was significant difference in preoperative chemotherapy group regarding relapse rate and treatment outcomes related to the lymph node status comparing to the upfront surgery group. Neoadjuvant/adjuvant chemo‐therapy is a part of treatment for patients with stage IIIA NSCLC, but further investigation is required to determine optimal treatment.

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“…Five-year survival following surgical resection without neoadjuvant or adjuvant therapy ranges from 5% for patients with clinically obvious N2 disease to 29% for those with occult N2 disease found within the pathologic specimen [1][2][3][4][5]. Numerous phase II and phase III trials of neoadjuvant chemotherapy or chemoradiation therapy suggest improved long-term patient survival with induction therapy followed by surgical resection [6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%