Treatment strategy for patients with surgically discovered N2 stage IIIA non-small cell lung cancer

Nakanishi, Ryoichi; Osaki, Toshihiro; Nakanishi, Kozo; Yoshino, Ichiro; Yoshimatsu, Takashi; Watanabe, Hideyuki; Nakata, Hajime; Yasumoto, Kosei

doi:10.1016/s0003-4975(97)00535-3

Cited by 44 publications

(42 citation statements)

References 17 publications

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“…If metastases were inhibited by the present and/or new therapies, the prognosis of patients with lung cancer would improve. According to new TNM revisions (Mountain, 1997), it is difficult to say if the 5-year survival rate of n ³ 2 in lung cancer patients is an improvement, although a standard operative technique has been established to resect mediastinal lymph nodes (Vansteenkiste et al, 1997), except for aortic lymph node metastasis (Nakanishi et al, 1997). Therefore, biological approaches and studies, such as interference with lymph node metastasis or management of downstaging to the patients with lymph node metastasis, combined with surgery are required for lung cancer therapy.…”

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confidence: 99%

Mediastinal lymph node metastasis model by orthotopic intrapulmonary implantation of Lewis lung carcinoma cells in mice

et al. 1999

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Lung neoplasm, in place of gastric cancer, is the major cause of cancer mortality in Japan as well as in the USA (Travis et al, 1995). Despite the advances in diagnostic techniques for the early detection of lung cancer and the significant improvement in surgical procedures, the survival rate of lung cancer patients is poor even in the early stages of cancer as compared to the other malignant neoplasms. From a clinical point of view, one of the most troublesome impediments for treatment of lung cancer is the metastasis to mediastinal lymph nodes (n = 2 and n = 3 lung cancer) from the primary lesion (Jefferson et al, 1996). If metastases were inhibited by the present and/or new therapies, the prognosis of patients with lung cancer would improve. According to new TNM revisions (Mountain, 1997), it is difficult to say if the 5-year survival rate of n ³ 2 in lung cancer patients is an improvement, although a standard operative technique has been established to resect mediastinal lymph nodes (Vansteenkiste et al, 1997), except for aortic lymph node metastasis (Nakanishi et al, 1997). Therefore, biological approaches and studies, such as interference with lymph node metastasis or management of downstaging to the patients with lymph node metastasis, combined with surgery are required for lung cancer therapy. To do this, suitable animal models that conform to the clinical features are also necessary to search for novel therapies of lung cancer and to evaluate the efficacy of new drugs. However, there are few models for the formation of a solitary pulmonary nodule by orthotopic implantation of lung cancer cells and subsequent lymph node metastasis. In the present study, we attempted to establish a simple model for a solitary lung tumour and its lymph node metastasis by intrapulmonary implantation of Lewis lung carcinoma (LLC) cells in mice. MATERIAL AND METHODS AnimalsSpecific pathogen-free female C57BL/6 mice at 6 weeks old, were purchased from Japan SLC, Inc, Hamamatsu, Japan. They were maintained in the Laboratory for Animal Experiments, Research Institute for Wakan-Yaku Toyama Medical and Pharmaceutical University, under laminar air-flow conditions. All animals had free access to standard laboratory mouse food and water ad libitum. Housing was temperature controlled with a 12-h light and dark cycle. This study was conducted in accordance with the standards established by the Guidelines for the Care and Use of Laboratory Animals of Toyama Medical and Pharmaceutical University. Summary This study is designed to establish a pulmonary tumour model to investigate the biology and therapy of lung cancer in mice. Current methods for forming a solitary intrapulmonary nodule and subsequent metastasis to mediastinal lymph nodes are not well defined. Lewis lung carcinoma (LLC) cell suspensions were orthotopically introduced into the lung parenchyma of C57/BL6 mice via a limited skin incision without thoracotomy followed by direct puncture through the intercostal space. The implantation process was performed within approximately ...

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confidence: 99%

Mediastinal lymph node metastasis model by orthotopic intrapulmonary implantation of Lewis lung carcinoma cells in mice

et al. 1999

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“…Miller et al [12], also reported that prognosis was better in patients with upper mediastinum involvement compared to patients with lower mediastinum involvement irrespective of the primary tumor localization. On the contrary, results of the study by Nakanishi et al [7], illustrates that the presence of superior, inferior, aorticopulmonary or extended lymph node metastasis in patients with N2 did not make a difference in terms of prognosis. Similarly, it was also asserted that no difference was identified between single N2 and multi N2 in terms of the survey.…”

Section: Discussionmentioning

confidence: 77%

“…However, Nakanishi reported that there is no difference between the patients with adenocarcinoma and patients with squamous cell carcinoma in terms of survival. Also, there is no difference between the patients with T1, T2, and T3 tumors in terms of the survival [7]. Moreover, no matter whether aorticopulmonary lymph node metastasis exists or not, a significant effect of histopathological type on survival was not observed in the left upper lobe tumors.…”

Section: Discussionmentioning

confidence: 86%

“…There are some studies evaluating the survival rates of N2 disease on the left upper lobe tumors that have isolated station 5 and/or 6th involvements on which surgical operation have been applied among mediastinal lymph node involvements, and studies evaluating the survival rates of single station N2 disease. These studies illustrate that survival rate for left upper lobe tumors where there is 5 and/or 6th station lymph node involvement is higher compared to other mediastinal lymph node involvements [5][6][7][8][9]. This study investigates the effect of 5 and/or 6th LN involvement, especially in cases with tumors located on the left upper lobe with the results obtained in the presence of the LN metastasis in NSCLC cases.…”

Section: Introductionmentioning

confidence: 94%

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The Effect of the Isolated Aorticopulmonary Lymph Node on Survival in Lung Cancer

Özkan¹

2016

Ann Clin Anal Med

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Anahtar KelimelerAortikopulmoner; Metastaz; Lenf Nodu; Akciğer Kanseri Abstract Aim: This study aims to investigate investigate the effects of aorticopulmonary LN metastasis and other N1 and N2 LN involvements on survival rates especially for left upper lobe tumors. Material and Method: 111 cases who underwent surgery due to NSCLC and were diagnosed with lymph node metastasis secondary to the postoperative pathological examination, were examined retrospectively. The cases on whom complete resection and mediastinal lymph node dissection were applied and who were diagnosed with postoperative mediastinal LN metastasis were examined with regard to the effects of some prognostic factors on survival. Results: 13 of the cases who were followed up for 21.41 months on average lost their lives. In the general survival analysis, it was found that isolated aorticopulmonary LN metastasis did not affect survival differently from other N2 diseases. Discussion: This paper claims that in cases with NSCLC located on the left upper lobe, isolated aorticopulmonary LN involvement does not have a negative effect on survival different from other N2 stations but further studies need for support this idea. Therefore, these cases should not be considered as inoperable and complete resection should be performed on the appropriate patients.

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“…[2] Literature review shows that most clinicians agree that NSCLC patients with N2 lymph node involvement are a heterogeneous group. [3,4] There had been many reports that tried to subclassify this population. [1,5,6] These studies showed that the disease prognosis was severe especially in the following clinical scenarios: Tumor cells involved multiple stations, subcarinal lymph node involvement, and presence of extracapsular extension.…”

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confidence: 99%

Prognostic factors in resectable pathological N2 disease of non-small cell lung cancer

Hsieh

Liu

et al. 2015

Biomed J

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Treatment strategy for patients with surgically discovered N2 stage IIIA non-small cell lung cancer

Cited by 44 publications

References 17 publications

Mediastinal lymph node metastasis model by orthotopic intrapulmonary implantation of Lewis lung carcinoma cells in mice

Mediastinal lymph node metastasis model by orthotopic intrapulmonary implantation of Lewis lung carcinoma cells in mice

The Effect of the Isolated Aorticopulmonary Lymph Node on Survival in Lung Cancer

Prognostic factors in resectable pathological N2 disease of non-small cell lung cancer

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