Importance of Routine Mediastinal Staging in Women With Nonsmall Cell Lung Cancer

Martín de Nicolás, J.L.; Gómez-Caro Andrés, A.; Moradiellos Díez, F.J.; Díaz-Hellín, V.; Gigirey Castro, O.; Larrú Cabrero, E.; Pérez Antón, J.A.; Fernández, C. Marrón

doi:10.1016/S1579-2129(06)60412-6

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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." "apellidos" => "Calpe" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906604114?idApp=UINPBA00003Z" "url" => "/15792129/0000004100000003/v1_201305150210/S1579212906604114/v1_201305150210/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Importance of Routine Mediastinal Staging in Women With Nonsmall Cell Lung Cancer" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "125" "paginaFinal" => "129" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "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" "autores" => array:8 [ 0 => array:2 [ "nombre" => "J.L." "apellidos" => "Martín de Nicolás" ] 1 => array:5 [ "preGrado" => "Dr." "nombre" => "A." "apellidos" => "Gómez-Caro Andrés" "email" => array:2 [ 0 => "abelitov@yahoo.es" 1 => "ablgomez@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "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" => "ObjectiveTO study the specific importance of mediastinal staging in women with nonsmall cell lung cancer. Patients and methodsBetween 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. ResultsCervical 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 (P <.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). ConclusionsRoutine mediastinoscopy is indicated for all women with nonsmall cell lung cancer, regardless of clinical stage." ] "es" => array:1 [ "resumen" => "ObjetivoInvestigar la importancia específica de la estadificación mediastínica de mujeres con carcinoma broncogénico, no microcítico. Pacientes Y MétodosEntre 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. ResultadosRealizamos 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). ConclusionesLa mediastinoscopia sistemática está indi-cada en todas las mujeres con carcinoma broncogénico no microcítico independientemente del estadio clínico." ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "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." ] ] "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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Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and basic research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Vol. 41. Issue 3.

Pages 125-129 (March 2005)

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Pages 125-129 (March 2005)

Original Article

DOI: 10.1016/S1579-2129(06)60412-6

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Importance of Routine Mediastinal Staging in Women With Nonsmall Cell Lung Cancer

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J.L. Martín de Nicolás, A. Gómez-Caro Andrés

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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

, F.J. Moradiellos Díez, V. Díaz-Hellín, O. Gigirey Castro, E. Larrú Cabrero, J.A. Pérez Antón, C. Marrón Fernández

Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain

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Abstract

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Objective

TO study the specific importance of mediastinal staging in women with nonsmall cell lung cancer.

Patients and methods

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.

Results

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 (P <.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).

Conclusions

Routine mediastinoscopy is indicated for all women with nonsmall cell lung cancer, regardless of clinical stage.

Key Words:

Mediastinoscopy

Women

Sex

Bronchogenic carcinoma

Objetivo

Investigar la importancia específica de la estadificación mediastínica de mujeres con carcinoma broncogénico, no microcítico.

Pacientes Y Métodos

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.

Resultados

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).

Conclusiones

La mediastinoscopia sistemática está indi-cada en todas las mujeres con carcinoma broncogénico no microcítico independientemente del estadio clínico.

Palabras clave:

Mediastinoscopia

Mujeres

Sexo

Carcinoma broncogénico

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REFERENCES

[1]

RJ Cerfolio, B Ojha, AS Bryant, CS Bass, AA Bartalucci, JM Mountz.

The role of FDG-PET scan in staging patients with nonsmall cell carcinoma.

Ann Thorac Surg., 76 (2003), pp. 861-866

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