ABSTRACT
Purpose:To explore the rational operative approach in patients with carcinoma of the middle third of the esophagus by T and N status as determined by preoperative CT scan. Methods:87 cases with carcinoma of the middle third of the esophagus chosen for the operative approach by CT findings entered the observational group, 118 cases with carcinoma of the middle third of the esophagus who were not scanned by CT were put into the control group. The observational group adopted different operative approaches by the relationship between the primary tumour and the aorta,and the relationship between the primary tumour and the azygos vein,and by the metastasis of regional lymph nodes. The operative approaches were chosen as follows:if the aorta was not involved, the operative approaches were chosen by the metastastatic status of the regional lymph nodes; left thoracoabdominal approaches were chosen,if the aorta was involved,and Ivor-Lewis operation was involved if the azygos vein was involved.The control group adopted the Ivor-Lewis operation. The rate of resection between two groups and the difference in positivity rates of the resected regional lymph node were analysed by chi-square test and T test. Results:Sensitivity of N staging by CT scan was 74.7%(65/87), and specificity of N staging was 60%(39/65). Sensitivity of diagnosis of the aorta involved by tumour by CT scan was 21.8%(19/87), and specificity was (26.3%)(5/19). The rate of resection in the observational group was 92%, and the rate of resection in the control group was'81.4%. Both were markedly different,P
ABSTRACT
Purpose:To investigate the relationship between involved extent of lymph node parenchyma and prognosis of patients with stageⅢ non-small-cell lung cancer (NSCLC) and define the appropriate surgical indications for the patients. Methods:From 1988 to 1998,one hundred and sixteen patients with NSCLC underwent systematic lymph node dissection and were diagnosed to have metastasis in mediastinal lymph node (N_(2) disease), whose clinical data were reviewed. According to the clinical and pathologic characteristics of the involved mediastinal lymph node, the patients were divided into subgroups. Survival rates were calculated and survival curves were prepared by Kaplan-Meier method. Survival differences among the subgroups were compared by Log-Rank test. Results:Involved extent of lymph node parenchyma had an important effect on the prognosis. In N_(2) disease with extra-capsular metastasis and intact capsule, 5-year survival rates were 9.8% and 18.8%, respectively. The survival difference between extra-capsular metastasis subgroup and inner-capsular metastasis subgroup was of statistical significance (P