The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma

We have examined the lymphadenectomy specimens from 92 consecutive cases of malignant mesothelioma undergoing extrapleural pneumonectomy from September 1999 through February 2005 inclusive

John G. Edwards

2006

Scholarcy highlights

  • We have examined the lymphadenectomy specimens from 92 consecutive cases of malignant mesothelioma undergoing extrapleural pneumonectomy from September 1999 through February 2005 inclusive
  • Positive N2 nodes inaccessible by mediastinoscopy were present in 17 cases
  • The most widely used in current practice is the TNM staging system proposed by the International Mesothelioma Interest Group in 1995 and subsequently adopted by the International Union Against Cancer
  • With regard to nodal metastasis, the same distinction between ipsilateral parenchymal-hilar and mediastinal nodes is made as for non–small cell lung cancer. This is reflected in the UICC TNM staging system, within which T1a designates multiple isolated tumor nodules over the parietal pleural surface, with the visceral surface remaining macroscopically normal
  • Significant positive findings in this study include the following: positive N2 nodes portend a worse prognosis than negative N2 nodes, patients with 4 or more positive nodes do worse than patients with less than 4 nodes, and patients with a greater proportion of positive nodes do worse
  • This is reflected in the Union Against Cancer TNM staging system, within which T1a designates multiple isolated tumor nodules over the parietal pleural surface, with the visceral surface remaining macroscopically normal

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