scholarly journals Radiotherapy for local recurrence of non-small-cell lung cancer after lobectomy and lymph node dissection—can local recurrence be radically cured by radiation?

2020 ◽  
Vol 50 (4) ◽  
pp. 425-433
Author(s):  
Yukihiro Terada ◽  
Mitsuhiro Isaka ◽  
Hideyuki Harada ◽  
Hayato Konno ◽  
Hideaki Kojima ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Small Cell Lung Cancer ◽  
Lymph Node Dissection ◽  
Local Control ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Node Dissection ◽  
Small Cell Lung

Abstract Background There is no standard therapeutic approach for local recurrence of non-small cell lung cancer (NSCLC) after complete resection. We investigated the outcomes of radiotherapy (RT) for patients with local recurrence. Methods We reviewed 46 patients who underwent curative-intent RT for local recurrence after lobectomy or pneumonectomy accompanied with mediastinal lymph node dissection between 2002 and 2014. We analyzed overall survival (OS), progression-free survival (PFS), local control, tumour response and the re-recurrence pattern. Results Among the 46 patients, 16 received concurrent chemotherapy. The median follow-up period was 48 months. The response rate was 91%. The 5-year OS and local control rates were 47.9 and 65.3%, respectively, and the 5-year PFS rate was 22.8%. Female sex and complete response to radiation were favourable prognostic factors. Of the 33 patients with recurrence after radiation, 32 (97%) had distant metastasis. Conclusions Although RT for local recurrence has high efficacy, distant relapse after radiation remains a major issue. Therefore, combination systemic therapy for local recurrence at any site should be further investigated. Since it is difficult to achieve a radical cure for local recurrence using RT, further study, for the administration of post-operative adjuvant therapy, is recommended.

Limited lymph node dissection in compromised patients of non-small cell lung cancer

Lung Cancer ◽  
2000 ◽  
Vol 29 (1) ◽  
pp. 138
Author(s):  
S Akamine ◽  
T Oka ◽  
T Takahashi ◽  
T Nagayasu ◽  
M Muraoka ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Lymph Node Dissection ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Node Dissection ◽  
Small Cell Lung ◽  
Limited Lymph Node Dissection ◽  
Compromised Patients

Surgical outcomes of early-stage small-cell lung cancer: single-center experience

2019 ◽  
Vol 27 (3) ◽  
pp. 187-191
Author(s):  
Muhammet Sayan ◽  
Merve Satir Turk ◽  
Ali Celik ◽  
Ismail Cuneyt Kurul ◽  
Abdullah Irfan Tastepe
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Lymph Node Dissection ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Mediastinal Lymph Node ◽  
Small Cell ◽  
Node Dissection ◽  
Small Cell Lung

Background Small-cell lung cancer is a highly aggressive and metastatic epithelial lung malignancy. A small percentage of these tumors can be detected at an early stage and may be appropriate for surgical treatment. We analyzed the data of patients with early-stage small-cell lung cancer who underwent lobectomy and mediastinal lymph node dissection. Methods Between January 2011 and December 2016, 26 patients with early-stage small-cell lung cancer underwent lobectomy and mediastinal lymph node dissection and were included the study. The mean age was 60.9 years and 18 (69.2%) were male. Patients with increased uptake of 18 F-fludeoxyglucose in mediastinal or distant organs on positron-emission tomography computed tomography, or lung resections other than lobectomy, were not included in the study. Results The most common tumor location was the right upper lobe. The diagnoses were achieved by intraoperative frozen section study in almost all patients (92.3%). Mean overall survival was 58.5 ± 6.7 months (range 45–71 months) and the 5-year survival rate was 53%. We found that a statistically significant correlation between lymph node metastasis in N1 or N2 stations and survival. There was also a significant relationship between N2 nodal metastasis and recurrence. Conclusion As stated in the current guidelines, lung lobectomy and mediastinal lymph node resection should be considered in early-stage small-cell lung cancers. Survival outcomes of surgery for early-stage small-cell lung cancer are similar to the results in non-small-cell lung cancer.

scholarly journals Sampling versus systematic full lymphatic dissection in surgical treatment of non-small cell lung cancer

2013 ◽  
pp. e2
Author(s):  
Georgios Koulaxouzidis ◽  
Grigorios Karagkiouzis ◽  
Marios Konstantinou ◽  
Ioannis Gkiozos ◽  
Konstantinos Syrigos
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Lymph Node Dissection ◽  
Cell Lung Cancer ◽  
Complete Resection ◽  
Small Cell ◽  
Node Dissection ◽  
Small Cell Lung ◽  
Term Survival

The extent of mediastinal lymph node assessment during surgery for non-small cell cancer remains controversial. Different techniques are used, ranging from simple visual inspection of the unopened mediastinum to an extended bilateral lymph node dissection. Furthermore, different terms are used to define these techniques. Sampling is the removal of one or more lymph nodes under the guidance of pre-operative findings. Systematic (full) nodal dissection is the removal of all mediastinal tissue containing the lymph nodes systematically within anatomical landmarks. A Medline search was conducted to identify articles in the English language that addressed the role of mediastinal lymph node resection in the treatment of non-small cell lung cancer. Opinions as to the reasons for favoring full lymphatic dissection include complete resection, improved nodal staging and better local control due to resection of undetected micrometastasis. Arguments against routine full lymphatic dissection are increased morbidity, increase in operative time, and lack of evidence of improved survival. For complete resection of non-small cell lung cancer, many authors recommend a systematic nodal dissection as the standard approach during surgery, and suggest that this provides both adequate nodal staging and guarantees complete resection. Whether extending the lymph node dissection influences survival or recurrence rate is still not known. There are valid arguments in favor in terms not only of an improved local control but also of an improved long-term survival. However, the impact of lymph node dissection on long-term survival should be further assessed by large-scale multicenter randomized trials.

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