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Ann Thorac Surg 2000;70:1624-1628
© 2000 The Society of Thoracic Surgeons

Original articles: general thoracic

Analyses of segmental lymph node metastases and intrapulmonary metastases of small lung cancer

Akira Yamanaka, MDa, Takashi Hirai, MDa, Toshio Fujimoto, MDa, Yohsuke Ohtake, MDa, Fumio Konishi, MDb

a Department of Chest Surgery, Fukui Red Cross Hospital, Fukui, Japan
b Department of Pathology, Fukui Red Cross Hospital, Fukui, Japan

Address reprint requests to Dr Yamanaka, Department of Chest Surgery, Fukui Red Cross Hospital, 2-4-1 Tsukimi, Fukui 918-8501, Japan
e-mail: akiray{at}mitene.or.jp

Background. Curativity and indications for limited resection of small peripheral lung cancer remain controversial.

Methods. Pathologic investigations of segmental lymph node metastases and intrapulmonary metastases in the resected lobe were performed for 94 small peripheral lung cancers (3.0 cm or less in diameter).

Results. Nine patients had segmental lymph node metastases, 1 had intrapulmonary metastases, and 1 had both. Of these 11 patients, 5 had metastases limited to the primary tumor-bearing segments, 2 had metastases in nonprimary tumor-bearing segments, and 4 had metastases in both. Of the 10 patients with segmental lymph node metastases, 7 had metastases in both lobar-hilar and mediastinal lymph nodes, and 3 of 8 with adenocarcinoma had a tumor 2.0 cm or less.

Conclusions. Segmentectomy seems more favorable than wedge resection, but the risk of remnant tumor remains as compared with lobectomy. Evaluation of lobar-hilar or mediastinal lymph nodes is helpful to determine the presence or absence of segmental lymph node metastases. Limited resection can be undertaken with smaller tumors to allow preservation of more lung function while accepting a somewhat enhanced risk of recurrence.




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