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Pattern of Metastasis Outside Tumor-Bearing Segments in Primary Lung Cancer: Rationale for Segmentectomy  Yuichi Sakairi, MD, PhD, Ichiro Yoshino, MD,

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Presentation on theme: "Pattern of Metastasis Outside Tumor-Bearing Segments in Primary Lung Cancer: Rationale for Segmentectomy  Yuichi Sakairi, MD, PhD, Ichiro Yoshino, MD,"— Presentation transcript:

1 Pattern of Metastasis Outside Tumor-Bearing Segments in Primary Lung Cancer: Rationale for Segmentectomy  Yuichi Sakairi, MD, PhD, Ichiro Yoshino, MD, PhD, Shigetoshi Yoshida, MD, PhD, Hidemi Suzuki, MD, PhD, Tetsuzo Tagawa, MD, PhD, Takekazu Iwata, MD, PhD, Teruaki Mizobuchi, MD, PhD  The Annals of Thoracic Surgery  Volume 97, Issue 5, Pages (May 2014) DOI: /j.athoracsur Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Schema of hilar and lobar, and intrapulmonary nodes. Intrapulmonary nodes (stations 13 and 14) were divided into two groups: inside tumor-bearing segmental nodes (gray circles) and outside tumor-bearing segmental nodes (open circles), according to the harbored segment. Stations 10 to 12 were considered hilar and lobar nodes (cross-hatched circles.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Primary tumor location. Primary lesions were observed in the following lobes: 77 (32%) in the right upper lobe, 17 (7%) in the right middle lobe, 44 (18%) in the right lower lobe, 72 (30%) in the left upper lobe, and 34 (14%) in the left lower lobe. (S = segment.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Tumor spread pattern. The algorithm shows a cascade based on three tumor-spread processes: (1) extrapulmonary nodal metastasis, (2) intrapulmonary spread, and (3) metastasis outside tumor-bearing segments. The number of lesions that fulfill each condition are shown, from the top: total lesions (black numbers), peripheral lesions (green numbers), and 20 mm or less peripheral lesions (red numbers). The single patient with metastasis on the outside of the tumor-bearing segment without any hilar or mediastinal nodal metastasis is noted by an asterisk (*). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

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