[Effect of extended lymph nodes dissection on curative resection of lung cancer]

We evaluated the effect of extended lymph nodes dissection on curative resection in 386 patients with lung cancer surgically treated for 9 years. The extended lymph node dissection of the hilar and mediastinum was performed on the basis of mapping system for mediastinal lymph nodes developed by Naruke. Altogether 2603 groups of lymph nodes were dissected (mean 6.74 groups). The overall metastatic rate was 49.2% (190/386), including simple N1 diseases (43 cases, 11.1%) and N2 diseases (147, 38.1%). The metastatic rate for squamous cell carcinoma, adenocarcinoma, small cell carcinoma and large cell carcinoma was 30.1%, 44.1%, 48.0% and 50.0%, respectively. The lymphatic metastases in lung cancer showed the features of saltatory infiltration and multiple levels of involvement. Cure could be achieved only after extended dissection of intrapulmonary and mediastinal lymph nodes.