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The Annals of Thoracic Surgery, Vol 50, 708-713, Copyright © 1990 by The Society of Thoracic Surgeons
T Ishida, T Yano, K Maeda, S Kaneko, M Tateishi and K Sugimachi
We have surgically treated 221 patients with a primary lung cancer 3.0 cm
or less in diameter. There were 8 patients with a tumor 1.0 cm or less in
diameter (group A), 84 with a tumor 1.1 to 2.0 cm in diameter (group B),
and 129 with a tumor 2.1 to 3.0 cm in diameter (group C). The incidence of
N0, N1, and N2 disease was 100%, 0%, and 0%, respectively, for patients in
group A; 83%, 5%, and 12% in group B; and 62%, 12%, and 25% in group C (N0
versus N2, p less than 0.01). For the 63 patients with regional lymph node
involvement, "skipping" metastasis was present in 28.6%. The 5-year
survival rate was 80% for group A, 74% for group B, and 51% for group C
(group B versus group C, p less than 0.01). Of the 121 patients who
underwent complete resection and were followed up for 5 years, 41% had
recurrence, 8% with local recurrence and 33% with distant metastasis.
Therefore, it is important to do as complete a resection as possible
together with mediastinal lymphadenectomy. Efforts to detect systemic
spread should be made at the time of preoperative evaluation, even when the
lung tumor is small.
ARTICLES
Strategy for lymphadenectomy in lung cancer three centimeters or less in diameter
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
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