The Impact of Superior Mediastinal Lymph Node Metastases on Prognosis in Non-small Cell Lung Cancer Located in the Right Middle Lobe

Sakao, Yukinori; Okumura, Sakae; Mun, Mingyon; Uehara, Hirofumi; Ishikawa, Yuichi; Nakagawa, Ken

doi:10.1097/jto.0b013e31820b8891

Cited by 19 publications

(12 citation statements)

References 12 publications

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“…This is supported by our results that show rare involvement of the interlobar nodes of the middle lobe. Third, the prognostic impact must be different from that for other lobes (9). The findings of our study were consistent with those of other reports, with the prognosis being significantly worse for patients with mediastinal LN metastases than for those with N1 nodes only.…”

Section: Discussionsupporting

confidence: 91%

“…In this report, the TI for #10 was comparable to that for UZ, but was lower than that for SCZ. Moreover, the incidence of #11s metastases (5.6%) was similar to that reported in a previous study (9). We hypothesized that #11i metastases were retrograde because antegrade drainage to the superior mediastinum from mediastinal metastasis was disturbed.…”

Section: Discussionsupporting

confidence: 85%

“…First, UZ and #11i metastases present significant adverse prognostic factors in patients with middle lobe lung cancer. Second, #11i metastases may result from mediastinal metastases (9). This is supported by our results that show rare involvement of the interlobar nodes of the middle lobe.…”

Section: Discussionsupporting

confidence: 74%

“…The pattern of lymphatic drainage from right middle lobe (RML) NSCLCs extends to both superior and inferior mediastinal lymph nodes (LNs); in fact, a high incidence of metastases to these nodal zones has been reported (7,8). Superior mediastinal and #11i LN metastases have been reported to be significant adverse prognostic factors in patients with middle lobe cancer and are associated with each other (9). However, only a few articles have evaluated the therapeutic value of LND during surgical resection of RML NSCLCs.…”

Section: Original Articlementioning

confidence: 99%

See 3 more Smart Citations

Therapeutic value of lymph node dissection for right middle lobe non-small-cell lung cancer

Kuroda¹,

Sakao²,

Mun³

et al. 2016

J. Thorac. Dis.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 74%

Section: Original Articlementioning

confidence: 99%

See 2 more Smart Citations

Therapeutic value of lymph node dissection for right middle lobe non-small-cell lung cancer

Kuroda¹,

Sakao²,

Mun³

et al. 2016

J. Thorac. Dis.

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“…In general, the characteristics of lung cancer arising from the middle lobe have been described as follows: 1) high frequency of extralobar invasion or pleural dissemination, and 2) numerous lymphatic drainage sites extending to both the superior and inferior mediastinal zones [4][5][6]. First, we demonstrated that the rate of incomplete resection was higher for cancers located in the RML than for those located in the other lobes.…”

Section: Commentmentioning

confidence: 71%

Characteristics of Non-Small Cell Lung Cancer Located in the Right Middle Lobe According to a Retrospective Study of Recurrence and Prognosis

Shimizu¹,

Hirami²,

Okita³

et al. 2012

OJTS

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Background: Some studies have suggested that among all cases of lung cancer, the outcome of lung cancer located in the right middle lobe (RML) is the worst. However, with the advances in the diagnosis and treatment methods of lung cancer over the last couple of decades, we investigated whether the prognosis of primary lung cancer located in the RML still remains inferior to that of lung cancer arising from other lobes. Methods: Between July 2003 and December 2011, 505 consecutive patients with non-small cell lung cancer (NSCLC) underwent surgical resection at our institution. Of these, 32 patients (6.3%) had tumors arising from the RML. Results: The rate of incomplete resection was higher for cancer located in the RML than that for cancer arising from other lobes. Significant associations were noted between cancer located in the RML and the rate of lymph node metastasis and initial locoregional recurrence. Multivariate analysis identified lymph node metastasis and location in the RML as independent risk factors influencing the recurrence-free survival (p = 0.006), although location in the RML was not extracted as an independent risk factor influenceing the overall survival (p = 0.060). Conclusion: Despite the recent advances in the treatment of lung cancer, evaluation of complete resection revealed that the outcome of cancer located in the RML is still the worst among cancer of all the lobes. Further early diagnosis and adjuvant therapy are needed for improving the prognosis of cancer located in the RML.

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Surgical Consideration Based on Lymph Nodes Spread Patterns in Patients with Peripheral Right Middle Non‐small Cell Lung Cancer 3 cm or Less

et al. 2020

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Background The optimal extent of lung resection and lymph nodes dissection for peripheral early-stage right middle non-small cell lung cancer (NSCLC) still remains controversial. In this study, we analyzed the patterns of lymph nodes metastasis (LNM) of patients with peripheral right middle NSCLC B 3 cm, aiming to provide evidences for surgical choice for early-stage peripheral right middle lobe NSCLC. Methods We retrospectively investigated the clinical and pathological data of patients diagnosed with peripheral right middle lobe NSCLC B 3 cm between January 2015 and December 2019. The LNM patterns were analyzed by tumor size.Results A total of 60 patients were included for analysis. The tumor size was preoperatively divided as follows: B 1 cm (13 patients); [ 1 cm but B 2 cm (36 patients); [ 2 cm but B 3 cm (11 patients). Fifty-four patients were categorized as N0 group, 1 patient as N1 group, and 5 patients as N2 group. In the upper zone, 3 patients were found to have LNM. In the subcarinal zone, another 3 patients had LNM. But the lymph nodes of all these patients were negative in the lower zone. In station 10, 1 patient (1.67%) was found to have LNM, while in station 11-13, 2 patients (3.33%) were found to have LNM. Conclusion For the right middle lobe peripheral NSCLC B 1 cm, sublobar resection with lymph node sampling may be a feasible treatment. For cancers [ 1 cm but B 2 cm, lobectomy with lobe-specific lymph node dissection (especially station 2R and 4R) may be a preferred choice. For tumors [ 2 cm but B 3 cm, lobectomy with systematic lymph node dissection may still be the standard of care.

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The Impact of Superior Mediastinal Lymph Node Metastases on Prognosis in Non-small Cell Lung Cancer Located in the Right Middle Lobe

Abstract: Superior mediastinal lymph node metastases and #11i metastases were significant adverse prognostic factors in patients with middle lobe lung cancer, and they were associated with each other.

Cited by 19 publications

References 12 publications

Therapeutic value of lymph node dissection for right middle lobe non-small-cell lung cancer

Therapeutic value of lymph node dissection for right middle lobe non-small-cell lung cancer

Characteristics of Non-Small Cell Lung Cancer Located in the Right Middle Lobe According to a Retrospective Study of Recurrence and Prognosis

Surgical Consideration Based on Lymph Nodes Spread Patterns in Patients with Peripheral Right Middle Non‐small Cell Lung Cancer 3 cm or Less

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