| Project/Area Number |
21591819
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Oita University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
YAMASHITA Shinichi 大分大学, 医学部, 准教授 (60444882)
TAKENO Shinsuke 大分大学, 医学部, 講師 (10347031)
YAMAMOTO Satoshi 大分大学, 医学部, 講師 (50343710)
MIYAWAKI Michiyo 大分大学, 医学部, 助教 (30404388)
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| Project Period (FY) |
2009 – 2011
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| Project Status |
Completed (Fiscal Year 2011)
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| Budget Amount *help |
¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2011: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2010: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2009: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
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| Keywords | 肺癌 / 胸腔鏡下両側縦隔リンパ節郭清 / 微小リンパ節転移 / skip metastasis / 両側縦隔リンパ節郭清 / 胸腔鏡手術 / 微小転移 / 左肺癌 / RT-PCR / 両側縦隔郭清 |
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| Research Abstract |
Background : Survival of patients with stage I non-small cell left lung cancer is not sufficient, probably, because of high incidence of the contralateral mediastinal node involvement. In this study, we investigated retrospectively occult micrometastases to the right upper mediastinal nodes in patients with stage I left lung cancer using a real-time quantitative reverse transcription-polymerase chain reaction(RT-PCR) method. Material and methods : 21 patients with clinical stage I non-small-cell left lung cancer underwent VATS lobectomy and bilateral mediastinal lymph node dissection(BMD). Clinical data and survival of patients with BMD were compared with those of 27 left-unilateral mediastinal node dissection(UMD). Occult micrometastases were detected using cytokeratin 19 mRNA RT-PCR method. Results : The operative time, blood loss, duration of chest tube drainage, and duration of postoperative hospital stay were not different between BMD and UMD patients. Pathological N2 disease was one patients. 20 patients had pN0 disease. Nodal micrometastases of right mediastinum were detected in 9/21(42. 8%) patients. Skip micrometastases to the level N3 nodes without the N1and N2 node involvement was observed in 7/9(77. 8%) patients. Patients with BMD are all alive and have no recurrence during median follow-up period of 13. 9 months. Overall 3-year survival and disease free 3-year survival of BMD patients were not significant difference from those of UMD patients. Conclusion : Thoracoscopic right upper mediastinal dissection for left lung cancer is safe and feasible. In our preliminary study, occult micrometastases to the level N3 nodes occurred frequently in patients with clinical N0 stage I non-small cell left lung cancer. Possibly, postoperative survival of patients with occult micrometastases to the level N3 node is not poor. Further follow up and work are needed.
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