Original articleGeneral thoracicSurgical Resection Is Justified in Non-Small Cell Lung Cancer Patients with Node Negative T4 Satellite Lesions
Section snippets
Material and Methods
We retrospectively reviewed our experience with surgical resection for the treatment of T4 satellite lesions at the University of Pittsburgh from 1999 to July 2007. This study was approved by the Institutional Review Board of the University of Pittsburgh. Because this was a retrospective study, individual consent was waived.
Patients who underwent resection for T4 (by virtue of satellite nodule) N0-2M0 were identified from the University of Pittsburgh cancer registry. Satellite lesions were
Patient Characteristics
A total of 51 patients (men 22, women 29) with a median age of 71 years (range, 48 to 87) with T4 (satellite lesion) N0-2 lesions treated who met the study criteria were identified over a 7-year period. Of these patients, the T4 N0 group was composed of 34 patients and the T4 N1-2 group was composed of 17 patients (N1 = 10; N2 = 7). Patient characteristics are summarized in Table 1, Table 2.
Preoperative Staging
The satellite nodule was identified preoperatively in 24 of 51 (47%) patients. The details of
Comment
The management of NSCLC depends on the stage and this is clearly one of the most important determinants of survival. Treatment decisions are made based on stage, and IIIB lesions are typically treated by nonoperative therapy except under certain circumstances. Patients who are classified as stage IIIB on the basis of one or more satellite nodules, in particular node negative patients, may be excellent candidates for surgical resection. In this article, we report the outcomes of node negative T4
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2015, Seminars in Radiation OncologyCitation Excerpt :High FDG uptake in a nodule is strongly correlated with malignancy, especially in the presence of known lung cancer. Patients with NSCLC often have additional pulmonary nodules that may represent satellite nodules adjacent to the primary tumor15,16 or more distant lesions that are suspicious for hematogenous metastasis.17 PET can help decide if satellite nodules should be included in the RT field or if palliative treatment should be delivered because of the presence of incurable lung metastases.
A dominant adenocarcinoma with multifocal ground glass lesions does not behave as advanced disease
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2012, Lung CancerCitation Excerpt :Although the numbers of cases were small, several investigators have also reported that EGFR and K-ras mutations occurred randomly in the same patients with multifocal lung cancers and/or AAHs [18,20,21,26,27]. Multiple primary lung cancers are potentially curable by surgical resection, especially in patients without nodal involvement [28,29]. In this series, no statistical differences in survival were observed between the patients with synchronous multifocal adenocarcinomas exhibiting the same clonality and patients with those exhibiting a different clonality.