2004 Volume 18 Issue 2 Pages 149-153
The surgical outcome of patients with persistent multiple N2 following preoperative induction therapy (IT) have been reported to be extremely poor. We adopted combined video-assisted mediastinoscopy and exploratory videoassisted thoracoscopy (MS+VATS) for restaging following IT in order to select good candidates for pulmonary resection, and report here on 4 pilot cases. Patient age ranged 56-70 years. Three males and 1 female were enrolled and histological diagnosis was adenocarcinoma in all patients. c-N2 was diagnosed by exploratory thoracoscopy in 1 patient, transbronchial needle aspiration cytology in 1, and conventional computed tomography in 2. As preoperative induction therapy, 3 patients received concurrent chemoradiation and 1 was treated with chemotherapy alone. MS+VATS showed neither mediastinal node involvement nor pleural dissemination in 3 patients who underwent curative pulmonary resection. However, MS+VATS detected persistent multiple N2 in 1 patient, whose cancer was regarded as unresectable. We propose that MS+VATS could be a useful strategy for restaging following IT in non-small cell lung cancer patients.
