Methastatic N2 in T1 Non-small cell lug cancer: Should we go back to invasive staging?

Methastatic N2 in T1 Non-small cell lug cancer: Should we go back to invasive staging?

Aim: T1 patients who were operated due to non-small cell lung cancer (NSCLC)were evaluated retrospectively. The objective of thisstudy was to evaluate metastatic lymph node status in T1 tumors and to discuss staging approaches in these tumors.Material and Methods: A total of 217 patients who met specified criteria between May 2012 and May 2019 were included in thestudy. Patients operated due to NSCLC who have a tumor size < 3 cm were evaluated in terms of age, gender, preoperative diagnosticmethods, thorax CT and PET-CT examinations, size, anatomic localization and histopathologic type of tumors, excised mediastinallymph nodes and pathology results.Results: Of total 292 lymph node stations sampled in patients with adenocarcinoma, 257 (89.73%) were reported as benign and30 (10.27) as malignant according to pathologic results. Of total 316 lymph node stations sampled in patients with squamous cellcarcinoma, 298 (94.3%) were benign and 18 (5.7%) were malignant.N2 positivity was found in 40 (18.43%) of the 217 patients.Conclusion: Mediastinoscopy should be performed for staging in the presence of a tumor size above 2 cm, histopathological type ofadenocarcinoma, high mass SUVmax values, lymph node with radiological growth and pathological involvement.

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  • 1. Goksel T, Yildiz P, Altin S, et al. Lung Cancer. In: Metintas M. ed. Turkish Thoracic Society, White Book, Ankara, Sentez Publishing 2010;1-3
  • 2. D’Amico TA, Wong TZ, Harpole DH, et al. Impact of computed tomography-positron emission tomography fusion in staging patients with thoracic malignancies. Ann Thorac Surg 2002;74:160-3
  • 3. Locicero J. Surgical Treatment of nonsmall cell lung cancer. In: Shields TW, Locicero J, Reed CE, Feins RH eds. General Thoracic Surgery. Philadelphia. Lippincott, Williams and Wilkins 2009;1311-41
  • 4. Veeramachaneni NK, Battafarano RJ, Meyers BF, et al. Risk factors for occult nodal metastasis in clinical T1N0 lung cancer: a negative impact on survival. Eur J Cardiothorac Surg 2008;33:466-9.
  • 5. Higashi K, Ito K, Hiramatsu Y, et al. 18F-FDG uptake by primary tumor as a predictor of intratumoral lymphatic vessel invasion and lymph node involvement in nonsmall cell lung cancer: analysis of a multicenter study. J Nucl Med 2005;46:267-73.
  • 6. Rusch VR, Crowley JJ, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the N descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol 2007;2:603-12.
  • 7. Reed CE, Silvestri GA. Diagnosis and staging of lung cancer. In: Shields TW, Locicero III J, Ponn RB, Rusch VW, eds. General Thoracic Surgery. Philedelphia: Lippincott Williams and Wilkins 2005;1534-47.
  • 8. Funatsu T, Matsubara Y, Hatakenaka R, et al.The role of mediastinoscopic biopsy in preoperative assessment of lung cancer. J Thorac Cardiovasc Surg 1992;104:1688-95.
  • 9. Hasdiraz L, Kahraman A, Bilgin M, et al. Mediastinoskopy for T1 Non-small Cell Lung Carcinoma. Turkiye Klinikleri J Med Sci 2007;27:677-9.
  • 10. Meyers BF, Haddad F, Siegel BA, et al. Costeffectiveness of routine mediastinoscopy in computed tomography- and positron emission tomographyscreened patients with stage I lung cancer. J Thorac Cardiovasc Surg 2006;131:822-9.
  • 11. Lee PC, Port JL, Korst RJ, eyt al. Risk factors for occult mediastinal metastases in clinical stage I nonsmall cell lung cancer. Ann Thorac Surg 2007;84:177-81.
  • 12. Rami-Porta R, Wittekind C, Goldstraw P. International Association for the Study of Lung Cancer (IASLC) Staging Committee. Complete resection in lung cancer surgery: proposed definition. Lung Cancer 2005;49:25-33.
  • 13. Ketchedjian A, Daly BD, Fernando HC, et al. Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma. J Thorac Cardiovasc Surg 2006;132:544-8.
  • 14. Goldstraw P1, Mannam GC, Kaplan DK, et al. Surgical management of non-small-cell lung cancer with ipsilateral mediastinal node metastasis (N2 disease). J Thorac Cardiovasc Surg 1994;107:19-27
Annals of Medical Research-Cover
  • Yayın Aralığı: 12
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Multi–functional intramedullary self-locking ulna nailing system: Proximal oblique locking without the need of fluoroscopic guidance, and it’s effects on olecranon joint surface

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Analysis of the neurology consultations in the emergency department and diagnostic accuracy of emergency physicians for the neurologic emergencies

Mehmet HAMAMCI, Sevilay VURAL, Nuray KILIÇ

Psychiatric disorders and characteristics of patients in asthmatic children and adolescents

Yakup ÇAĞ, Funda GÜMÜŞTAŞ, Yasemin YULAF

Does postimplantation syndrome due to endovascular aneurysm repair increase mortality rate?

Selen ÖZTÜRK, İbrahim ÖZTÜRK, Betül ŞEN, Habip YILMAZ

Percutaneous dilatation tracheostomy at liver transplantation intensive care unit by surgeons

Cemalettin KOÇ

A comparison of outcomes between Syrian and Turkish patients with traumatic brain injury admitted to intensive care in Gaziantep, Turkey, two border sharing countries

Ali Muhittin TAŞDOĞAN, Ebru TARIKÇI KILIÇ

Sociodemographic and obstetric characteristics as predictors of anxiety during pregnancy

Mesude DUMAN http://orcid.org/0000-0002-5021-2699, Yeter DURGUN OZAN

Concordance of diffusion tensor imaging alterations with EEG lateralization in MR negative refractory temporal lobe epilepsy

Özden ÇALIŞKAN KAMIŞLI, Mehmet Fatih ERBAY

Decreased serum periostin level is associated with carpal tunnel syndrome

Hikmet SAÇMACI, Seda SABAH ÖZCAN, Murat ÇAKIR

Clinical and hormonal characteristics of women with various phenotypes of polycystic ovary syndrome

Abdullah KARAER, Senem ARDA DÜZ, Görkem TUNCAY