The value of the bilateral iliac crest needle biopsy for the pretherapeutic tumor staging of lung cancer — results from a TNM field study


Lun 02 SURGICAL RESECTION OF LUNG CANCER: PROGNOSTIC SIGNIFICANCE OF T~ STAGING L.S~Tder-Piassmann (a.G.), H. Dienemann (a.G.), G. Heberer L~g cancer is the most frequent malignant disease in the male population, accounting for 37% of certif ied causes of death from all malignant diseases (M. Bates: Bronchial carcinoma, Springer Berlin 1984). There is s t i l l general agreement in the literature that surgical resection of al l non small cell types s t i l l carries the best prognosis providing an overall f ive year survival rate of approx. 25%. Marked progress in surgery and anesthesiology has decreased operative mortality of lobectomy and pneur~nectomy from 15 2(Y/~ down to 2-5 %. However i t has been pointed out repeatedly that al l propress in surgical techniques has not been able to improve overall survival figures within the past 30 years: Longtem sucess of surgery is extremiy dependant upon TN~ staging: 5 year survival in TI NO tomors is reported up to 9(Y/o, whereas TX N2 tomors carry a poor prognosis with 5 years survival of approx. 13% (N. Martini 1982). In our own group of 464 patient, resected for lung cancer from 1979 to 1985 only 13% were TI tunors 'whereas in 64% the tomor had increased to T2 and in 23% to T3 stages. Inf i l trat ion of mediastinal lymphnodes (LN) which carries the worst prognosis was found in almost one f i f th of al l resections, perioperative mortality was 2% for lobectomy and pneu~onectomy. Hilar and mediastinal LN staging was carried out in every patient, radical mediastinal LN dissection performed whenever lymphnodes where found to be enlarged. In contrast to general beleave only 40% of enlarged LN (~ 2cm) were infi l trated by carcinoma whereas 6~ were enlarged by nonspecific l~ffnphadeniti s. From our experience we conclude that: I. Early diagnosis of bronchial cancer has to be improved, since late results of surgery are excellent in early bronchial cancer and operative mortality is low (e,~ 2 %). 2. Mediastinal lymphnode enlargement per se does not preclude curative resection. LN staging and radical dissection however is a must. 3. Postoperative r-F~diation of positive mediastinal l~nphnodes needs further docomentation. Chirurgische Klinik und Polikiinik, Kliniku~ GroBhadern, MarchioninistraBe 15, I)-8000 Mi~chen 70

DOI: 10.1007/BF02580027

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@article{Manegold2007TheVO, title={The value of the bilateral iliac crest needle biopsy for the pretherapeutic tumor staging of lung cancer — results from a TNM field study}, author={Ch. Manegold and Heinrich B{\"{u}lzebruck and Burkhard Krempien and Peter Drings}, journal={Journal of Cancer Research and Clinical Oncology}, year={2007}, volume={111}, pages={S64-S64} }