OJTS  Vol.2 No.3 , September 2012
Characteristics of Non-Small Cell Lung Cancer Located in the Right Middle Lobe According to a Retrospective Study of Recurrence and Prognosis
ABSTRACT
Background: Some studies have suggested that among all cases of lung cancer, the outcome of lung cancer located in the right middle lobe (RML) is the worst. However, with the advances in the diagnosis and treatment methods of lung cancer over the last couple of decades, we investigated whether the prognosis of primary lung cancer located in the RML still remains inferior to that of lung cancer arising from other lobes. Methods: Between July 2003 and December 2011, 505 consecutive patients with non-small cell lung cancer (NSCLC) underwent surgical resection at our institution. Of these, 32 patients (6.3%) had tumors arising from the RML. Results: The rate of incomplete resection was higher for cancer located in the RML than that for cancer arising from other lobes. Significant associations were noted between cancer located in the RML and the rate of lymph node metastasis and initial locoregional recurrence. Multivariate analysis identified lymph node metastasis and location in the RML as independent risk factors influencing the recurrence-free survival (p = 0.006), although location in the RML was not extracted as an independent risk factor influenceing the overall survival (p = 0.060). Conclusion: Despite the recent advances in the treatment of lung cancer, evaluation of complete resection revealed that the outcome of cancer located in the RML is still the worst among cancer of all the lobes. Further early diagnosis and adjuvant therapy are needed for improving the prognosis of cancer located in the RML.

Cite this paper
K. Shimizu, Y. Hirami, R. Okita, S. Saisho, T. Yukawa, A. Maeda, K. Yasuda and M. Nakata, "Characteristics of Non-Small Cell Lung Cancer Located in the Right Middle Lobe According to a Retrospective Study of Recurrence and Prognosis," Open Journal of Thoracic Surgery, Vol. 2 No. 3, 2012, pp. 52-57. doi: 10.4236/ojts.2012.23012.
References
[1]   Gifford JH, Waddington JK. Review of 464 cases of carcinoma of lung treated by resection. Br Med J, Vol. 30, 1957, pp.723-730. doi:10.1136/bmj.1.5021.723

[2]   Vincent RG, Takita H, Lane WW, Gutierrez AC, Pickren JW. Surgical therapy of lung cancer. J Thorac Cardiovasc Surg, Vol. 71, 1976, pp. 581-591.

[3]   Freise G, Gabler A, Liebig S. Bronchial carcinoma and long-term survival. Retrospective study of 433 patients who underwent resection. Thorax, Vol. 33, 1978, pp. 228-234. doi:10.1136/thx.33.2.228

[4]   Miura H, Kato H, Konaka C, Usuda J, Uchida O, Taira O. Primary lung cancer of the middle lobe. Is its prognosis poor? Lung Cancer, Vol. 14, 1996, pp. 273-279. doi:10.1016/0169-5002(96)00553-3

[5]   Asamura H, Nakayama H, Kondo H, Tsuchiya R, Naruke T. Lobe-specific extent of systematic lymph node dissection for non-small cell lung carcinomas according to a retrospective study of metastasis and prognosis. J Thorac Cardiovasc Surg, Vol. 117, 1999, pp.1102-1111. doi:10.1016/S0022-5223(99)70246-1

[6]   Sakao Y, Okumura S, Mingyon M, Uehara H, Ishikawa Y, Nakagawa K. The impact of superior mediastinal lymph node metastases on prognosis in non-small cell lung cancer located in the right middle lobe. J Thorac Oncol, Vol. 6, 2011, pp. 494-499. doi:10.1097/JTO.0b013e31820b8891

 
 
Top