Thoracoscopic Staging of IIIB Non–Small Cell Lung Cancer Before Neoadjuvant Therapy
Section snippets
Material and Methods
From January 1993 to March 1996, 64 patients with suspected IIIB non–small cell lung cancer were seen at our department. Clinical staging was accomplished by fiberoptic bronchoscopy, total body computed tomography, bone scan, and magnetic resonance imaging in selected patients. Five patients with vocal cord paralysis, 4 with cancer extension in the trachea demonstrated by fiberoptic bronchoscopy, 2 with superior vena cava syndrome, and 10 with malignant pleural effusion with positive cytology
Results
No complications related to VAT occurred (Table 1). The chest tube was removed 24 to 36 hours after the operation and all VAT patients were discharged from hospital on the first or second postoperative day. In 10 patients in group I, frozen sections showed malignant pleural involvement in 6 patients. Therefore, these patients were referred for chemotherapy and radiation therapy. In the remaining 4 patients, pleural biopsies were negative for cancer infiltration and VAT was converted to
Comment
Neoadjuvant therapy has become a well-accepted approach for stage IIIA non–small cell lung cancer. Its efficacy is being evaluated for stage IIIB, which is usually considered to be locally advanced lung cancer, incurable, and not surgically treated. However, it is often difficult to assess and compare the outcome of stage IIIB patients if they are only clinically staged. In fact, the lack of histologic confirmation of the real extent of the tumor makes it difficult to distinguish which patients
References (11)
- et al.
and the Cancer and Leukemia Group B Thoracic Surgery Group. Results of cancer and leukemia group B protocol 8935. A multiinstitutional phase II trial for stage IIIA (N2) non-small cell lung cancer
J Thorac Cardiovasc Surg
(1995) - et al.
Surgical resection of stage IIIA and stage IIIB non-small cell lung cancer after concurrent induction chemotherapy
J Thorac Cardiovasc Surg
(1993) - et al.
Computed tomography for the evaluation of intrathoracic invasion by lung cancer
J Thorac Cardiovasc Surg
(1987) - et al.
Comparative merits of thoracoscopy, mediastinoscopy and mediastinotomy for mediastinal biopsy
Ann Thorac Surg
(1994) Video assisted thoracoscopy and the staging of lung cancer
Ann Thorac Surg
(1993)