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Validity of using lobe-specific regional lymph node stations to assist navigation during lymph node dissection in early stage non-small cell lung cancer patients

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Abstract

Purpose

The validity of our proposed lobe-specific regional lymph node stations (LSRLNS) was evaluated as a method for navigation during lymphadenectomy in patients with early stage non-small cell lung cancer (NSCLC).

Methods

A total of 725 NSCLC patients with c-T2N1M0 or less extensive disease who had undergone a curative operation with complete mediastinal lymph node dissection (MLND) were studied. The LSRLNS were #2, #3, #4 and #10 for the right upper lobe, #11i, #11s, #7 and #8 for the right lower lobe, #4, #5 and #6 for the left superior division, #11, #5 and #7 for the left lingular division and #11, #7 and #8 for the left lower lobe.

Results

If the LSRLNS were used for pathological examinations during surgery, 599 p-N0 and 39 p-N1 patients diagnosed with no metastasis would have been subjected to a selective MLND, while 20 p-N1 and 65 p-N2 patients who had a diagnosis of metastasis would have been navigated to a complete MLND. Two p-N2 patients with a diagnosis of no metastasis would have inappropriately undergone a selective MLND, resulting in the false negative rate at 0.3 %.

Conclusion

Intra-operative pathological examination using our LSRLNS may accurately reveal the status of metastasis, and appropriately lead to a selective or complete MLND in patients with c-T2N1M0 or less extensive disease.

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Conflicts of interest

Shinichiro Miyoshi and the co-authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Shinichiro Miyoshi, Kazuhiko Shien, Shinichi Toyooka, Kentaroh Miyoshi, Hiromasa Yamamoto, Seiichiro Sugimoto, Junichi Soh, Makio Hayama, Masaomi Yamane & Takahiro Oto

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  1. Shinichiro Miyoshi
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  2. Kazuhiko Shien
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  3. Shinichi Toyooka
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  4. Kentaroh Miyoshi
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  5. Hiromasa Yamamoto
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  6. Seiichiro Sugimoto
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  7. Junichi Soh
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  8. Makio Hayama
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  9. Masaomi Yamane
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  10. Takahiro Oto
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Correspondence to Shinichiro Miyoshi.

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Miyoshi, S., Shien, K., Toyooka, S. et al. Validity of using lobe-specific regional lymph node stations to assist navigation during lymph node dissection in early stage non-small cell lung cancer patients. Surg Today 44, 2028–2036 (2014). https://doi.org/10.1007/s00595-013-0772-5

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  • DOI: https://doi.org/10.1007/s00595-013-0772-5

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