Abstract
Between January 1980 and April 1995, 1141 patients with primary lung cancer underwent surgical resection of the lung in our institution. In this study, we retrospectibely reviewed 106 patients among them with primary lung cancer of the right or left upper lobe, who had complete mediastinal dissection (R2a or R2b) and were diagnosed to have pN2-stage IIIA. The primary lesion was located in the right lung in 54 patients, and left in 52 patients. The nodal involvement at various lymph node sites was evaluated. The involvement of #4 and #3 node was observed more on the right side, while #5 and #6 nodal involvement was observed more on the left side. #7-#9 nodal involvement was rare, and it occurred in 16 cases (15.1%) in the site #7, 2 cases (1.8%) in #8, and 1 case (0.9%) in #9. We classified the 106 patients into the two groups, 16 with #7, #8 or#9 node positive cases, and 90 with #7. #8 and #9 node negative cases, and compared the clinical profile and prognosis of the groups. The five year survial rates of patients with pN2-STAGE IIIA upper lobe primary lung cancer were 12.7% in #7-#9 node positive cases and 37.1% in #7-#9 node negative cases, respectibely. The survival rate of #7-#9 node positive patients was significantly poorer than that of #7-#9 node negative patients. We conclude that subcarinal and inferior mediastibnal lymph node dissection is not necessary to improve the prognosis in patients with pN2-stage IIIA upper lobe primary lung cancer, but is essential in evaluating the accurate staging of the disease.
