Original Article
Importance of Routine Mediastinal Staging in Women With Nonsmall Cell Lung Cancer
J.L. Martín de Nicolás, A. Gómez-Caro Andrés
, F.J. Moradiellos Díez, V. Díaz-Hellín, O. Gigirey Castro, E. Larrú Cabrero, J.A. Pérez Antón, C. Marrón Fernández
Corresponding author
abelitov@yahoo.es
ablgomez@hotmail.com
Correspondence: Dr. A. Gómez-Caro Andrés. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,400. Madrid. España
ablgomez@hotmail.com
Correspondence: Dr. A. Gómez-Caro Andrés. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,400. Madrid. España
Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain
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Calpe, E. Chiner, J. Marín, V. Armero, A. Calpe" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J.L." "apellidos" => "Calpe" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Chiner" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Marín" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Armero" ] 4 => array:3 [ "preGrado" => "Dr." "nombre" => "A." 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"apellidos" => "Gómez-Caro Andrés" "email" => array:2 [ 0 => "abelitov@yahoo.es" 1 => "ablgomez@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 2 => array:2 [ "nombre" => "F.J." "apellidos" => "Moradiellos Díez" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Díaz-Hellín" ] 4 => array:2 [ "nombre" => "O." "apellidos" => "Gigirey Castro" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Larrú Cabrero" ] 6 => array:2 [ "nombre" => "J.A." "apellidos" => "Pérez Antón" ] 7 => array:2 [ "nombre" => "C. Marrón" "apellidos" => "Fernández" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. A. Gómez-Caro Andrés. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,400. Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-04-13" "fechaAceptado" => "2004-06-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153973" "palabras" => array:4 [ 0 => "Mediastinoscopy" 1 => "Women" 2 => "Sex" 3 => "Bronchogenic carcinoma" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153974" "palabras" => array:4 [ 0 => "Mediastinoscopia" 1 => "Mujeres" 2 => "Sexo" 3 => "Carcinoma broncogénico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO study the specific importance of mediastinal staging in women with nonsmall cell lung cancer.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Between July 1981 and September 2003 we surgically staged 2172 patients with nonsmall cell lung cancer who met the inclusion criteria for resectability and operability. A subgroup of 108 women was studied. Cervical mediastinoscopy was performed in all cases, with the addition of anterior mediastinotomy in cases with left upper lobe involvement. All patients underwent a preoperative computed tomography chest scan.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Cervical mediastinoscopy was performed on all 108 patients, 26 of whom also underwent anterior mediastinotomy. Positive findings were recorded in 44 (40.7%) of the 108 cases: 39 of the 108 mediastinoscopies (36.1%), 9 of the 26 mediastinotomies (34.6%), and in 5 cases (19.2%) both mediastinoscopy and mediastinotomy. Nodal involvement was found in 13% of cases in clinical stage IA and 30.8% of cases in clinical stage IB. The percentage of positive findings was significantly higher for cases with adenocarcinoma or large cell carcinoma (<span class="elsevierStyleItalic">P</span> <.05). We performed 67 thoracotomies: 46 patients underwent lobectomy (42.6% of the 108), 7 bilobectomy (6.5%), 9 pneumonectomy (8.3%), and 5 exploratory thoracotomy (4.6%). The agreement between clinical staging after mediastinoscopy and pathological staging after thoracotomy was 47% (stage IA) and 57% (stage IB).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Routine mediastinoscopy is indicated for all women with nonsmall cell lung cancer, regardless of clinical stage.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Investigar la importancia específica de la estadificación mediastínica de mujeres con carcinoma broncogénico, no microcítico.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Entre julio de 1981 y septiembre de 2003 estadificamos quirúrgicamente a 2.172 pacientes con carcinoma broncogénico no microcítico que cumplían criterios de resecabilidad y operabilidad. Se realizó medias-tinoscopia cervical de forma habitual, y mediastinotomía anterior en caso de afectación del lóbulo superior izquierdo. Todos los pacientes tenían una tomografía axial computari-zada de tórax preoperatoria. Se estudió al subgrupo de 108 mujeres.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Realizamos mediastinoscopia cervical en 108 casos y mediastinotomía anterior en 26. Fueron positivas 44 (40,7%) -39 (36,1%) mediastinoscopias, 9 (34,6%) mediastinotomías y en 5 (19,2%) casos ambas—. Se objetivó afectación ganglionar en un 13% de los casos en estadio IA y en un 30,8% en estadio IB. El porcentaje de positivi-dad fue significativamente mayor en caso de adenocarcinoma o carcinoma de células grandes (p < 0,05). Realizamos 67 toracotomías: 46 (42,6%) lobectomías, 7 (6,5%) bilobectomías, 9 (8,3%) neumonectomías y 5 (4,6%) toracotomías exploradoras. La concordancia entre estadificación clínica posmediastinoscopia y patológica postoracotomía fue del 47% (IA) y del 57% (IB).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La mediastinoscopia sistemática está indi-cada en todas las mujeres con carcinoma broncogénico no microcítico independientemente del estadio clínico.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This article was presented at the Third International Workshop on Surgical Exploration of the Mediastinum and Systematic Nodal Dissection, held in Terrassa, Barcelona, Spain, in November, 2003.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of FDG-PET scan in staging patients with nonsmall cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "RJ Cerfolio" 1 => "B Ojha" 2 => "AS Bryant" 3 => "CS Bass" 4 => "AA Bartalucci" 5 => "JM Mountz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 26 | 15 | 41 |
| 2024 September | 27 | 15 | 42 |
| 2024 August | 39 | 33 | 72 |
| 2024 July | 26 | 20 | 46 |
| 2024 June | 29 | 22 | 51 |
| 2024 May | 32 | 30 | 62 |
| 2024 April | 23 | 29 | 52 |
| 2024 March | 20 | 16 | 36 |
| 2024 February | 18 | 22 | 40 |
| 2023 March | 2 | 5 | 7 |
| 2023 February | 16 | 17 | 33 |
| 2023 January | 18 | 42 | 60 |
| 2022 December | 18 | 17 | 35 |
| 2022 November | 22 | 20 | 42 |
| 2022 October | 19 | 28 | 47 |
| 2022 September | 16 | 26 | 42 |
| 2022 August | 19 | 32 | 51 |
| 2022 July | 18 | 38 | 56 |
| 2022 June | 13 | 32 | 45 |
| 2022 May | 25 | 41 | 66 |
| 2022 April | 15 | 42 | 57 |
| 2022 March | 15 | 35 | 50 |
| 2022 February | 16 | 25 | 41 |
| 2022 January | 14 | 39 | 53 |
| 2021 December | 12 | 38 | 50 |
| 2021 November | 15 | 40 | 55 |
| 2021 October | 17 | 35 | 52 |
| 2021 September | 16 | 44 | 60 |
| 2021 August | 11 | 24 | 35 |
| 2021 July | 15 | 31 | 46 |
| 2021 June | 16 | 37 | 53 |
| 2021 May | 18 | 20 | 38 |
| 2021 April | 47 | 68 | 115 |
| 2021 March | 26 | 13 | 39 |
| 2021 February | 10 | 15 | 25 |
| 2021 January | 12 | 7 | 19 |
| 2020 December | 10 | 15 | 25 |
| 2020 November | 7 | 14 | 21 |
| 2020 October | 5 | 10 | 15 |
| 2020 September | 8 | 7 | 15 |
| 2020 August | 31 | 7 | 38 |
| 2020 July | 51 | 20 | 71 |
| 2020 June | 12 | 9 | 21 |
| 2020 May | 18 | 16 | 34 |
| 2020 April | 15 | 11 | 26 |
| 2020 March | 7 | 16 | 23 |
| 2020 February | 14 | 21 | 35 |
| 2020 January | 16 | 20 | 36 |
| 2019 December | 14 | 18 | 32 |
| 2019 November | 8 | 18 | 26 |
| 2019 October | 6 | 9 | 15 |
| 2019 September | 4 | 19 | 23 |
| 2019 August | 7 | 7 | 14 |
| 2019 July | 8 | 20 | 28 |
| 2019 June | 9 | 11 | 20 |
| 2019 May | 7 | 15 | 22 |
| 2019 April | 18 | 20 | 38 |
| 2019 March | 13 | 22 | 35 |
| 2019 February | 5 | 16 | 21 |
| 2019 January | 3 | 14 | 17 |
| 2018 December | 6 | 19 | 25 |
| 2018 November | 16 | 10 | 26 |
| 2018 October | 19 | 15 | 34 |
| 2018 September | 11 | 14 | 25 |
| 2018 May | 1 | 1 | 2 |
| 2018 April | 6 | 6 | 12 |
| 2018 March | 10 | 7 | 17 |
| 2018 February | 9 | 13 | 22 |
| 2018 January | 8 | 8 | 16 |
| 2017 December | 3 | 5 | 8 |
| 2017 November | 4 | 3 | 7 |
| 2017 October | 6 | 15 | 21 |
| 2017 September | 5 | 6 | 11 |
| 2017 August | 7 | 9 | 16 |
| 2017 July | 3 | 4 | 7 |
| 2017 June | 11 | 11 | 22 |
| 2017 May | 7 | 9 | 16 |
| 2017 April | 5 | 5 | 10 |
| 2017 March | 5 | 4 | 9 |
| 2017 February | 4 | 10 | 14 |
| 2017 January | 3 | 2 | 5 |
| 2016 December | 10 | 7 | 17 |
| 2016 November | 19 | 9 | 28 |
| 2016 October | 20 | 9 | 29 |
| 2016 September | 8 | 6 | 14 |
| 2016 August | 5 | 4 | 9 |
| 2016 May | 1 | 0 | 1 |
| 2016 March | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 35 | 1 | 36 |
| 2015 September | 29 | 11 | 40 |
| 2015 August | 26 | 8 | 34 |
| 2015 July | 38 | 6 | 44 |
| 2015 June | 24 | 2 | 26 |
| 2015 May | 38 | 7 | 45 |
| 2015 April | 27 | 9 | 36 |
| 2015 March | 28 | 6 | 34 |
| 2015 February | 22 | 7 | 29 |
| 2015 January | 31 | 6 | 37 |
| 2014 December | 30 | 5 | 35 |
| 2014 November | 26 | 6 | 32 |
| 2014 October | 45 | 9 | 54 |
| 2014 September | 31 | 6 | 37 |
| 2014 August | 39 | 7 | 46 |
| 2014 July | 41 | 8 | 49 |
| 2014 June | 40 | 4 | 44 |
| 2014 May | 41 | 6 | 47 |
| 2014 April | 44 | 8 | 52 |
| 2014 March | 54 | 6 | 60 |
| 2014 February | 43 | 7 | 50 |
| 2014 January | 39 | 7 | 46 |
| 2013 December | 40 | 6 | 46 |
| 2013 November | 36 | 4 | 40 |
| 2013 October | 39 | 6 | 45 |
| 2013 September | 40 | 6 | 46 |
| 2013 August | 42 | 4 | 46 |
| 2013 July | 59 | 21 | 80 |
| 2013 June | 40 | 6 | 46 |
| 2013 May | 31 | 4 | 35 |
| 2013 April | 21 | 5 | 26 |
| 2013 March | 6 | 2 | 8 |
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