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See Latest ArticlesSurvival and Risk Factors of Surgically Treated Mediastinal Invasion T4 Non-Small Cell Lung Cancer
Annals of Thoracic Surgery, 08/04/09
Yang HX et al. – N2–positive, T4 NSCLC with mediastinal involvement is not suitable for resection. T4 NSCLC patients with pulmonary great vessel involvement had better survival rates than other T4 subgroups. Pneumonectomy should be done with caution due to a high mortality risk and poor prognosis. Further studies are warranted to assess the role of sex on survival.
Dr Jian-hua Fu, Hao-xian Yang, 08/07/09
| Locally advanced disease accounts for a large proportion of patients with non-small cell lung cancer (NSCLC). For some selected T4 patients without mediastinal lymph node metastasis, surgery may give a survival benefit provided that the tumor can be completely resected. However, 27.4% (40/146) patients underwent incomplete resection in our data (including 15 cases with only thoracotomy exploratory). The high proportion of incomplete patients suggests that we should carry out more effective strategies for staging. Although the mediastinoscopy has not been equipped in many hospitals in China, we believe it is essential in the staging for NSCLC. Mediastinoscopy examination should be considered as routine strategy in staging to role out N2 positive patients from direct surgery. |
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