• T Shiraishi, M Hiratsuka, Y Yoshinaga, S Yamamoto, A Iwasaki, and T Shirakusa.
• Department of Surgery II, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka City, Fukuoka, Japan. tshiraishi-ths@umin,ac.jp
• Thorac Cardiovasc Surg. 2008 Apr 1; 56 (3): 162-6.

IntroductionThe impact of thoracoscopic systemic lymph node dissection (LND) on loco-regional control of non-small cell lung cancer (NSCLC) with positive lymph node metastasis was investigated.Patients And MethodsThoracoscopic lobectomy with systemic LND was performed for clinical stage I NSCLC. 340 patients were admitted for either a thoracoscopic (n = 98) or a standard open (n = 242) lobectomy with systemic LND. Of those 340 cases, 75 cases (20 thoracoscopic and 55 open) were pathologically diagnosed with node-positive disease. A retrospective chart review of these 75 cases was performed.ResultsNo significant difference in the overall or loco-regional recurrence-free survival was observed between the groups. The results of a multivariate analysis of the overall and the loco-regional recurrence-free survival demonstrated that the significant factors were tumor size for overall recurrence-free survival, and sex and surgical procedure (use of thoracoscopic surgery) for loco-regional recurrence-free survival, respectively.ConclusionIn general, thoracoscopic lobectomy for c-stage I disease may have no survival disadvantage over open procedures. It might, however, increase the risk of local recurrence when used to treat pathologically node-positive disease. Caution should be used when treating those cases with thoracoscopic surgery.

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