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J.Jpn. Surg. Soc.. 114(1): 28-33, 2013


Feature topic

CLINICAL SIGNIFICANCE OF MICROMETASTASES IN THE LYMPH NODES OF PATIENTS WITH RESECTABLE LUNG CANCER

1) Department of Chest Surgery, Iizuka Hospital, Iizuka
2) Director, Shin-Komonji Hospital, Kitakyushu
3) Emeritus Professor, University of Occupational and Environmental Health, Kitakyushu, Japan

Toshihiro Osaki1), Kosei Yasumoto2)3)

Clinical evaluation of micrometastases in the lymph nodes of lung cancer patients is not currently recommended in guidelines because of several different results concerning their prevalence and prognostic implications. However, a recent large, prospective, multicenter clinical study has shown a significant prognostic impact of micrometasteses in the lymph nodes of patients with resectable lung cancer; therefore, the clinical significance of micrometastases as predictive markers of recurrence and prognosis has begun to be clarified. From the viewpoint of surgery for lung cancer, sentinel node navigation surgery, segmentectomy, and individualized therapies such as adjuvant chemotherapy are expected to be developed. In the near future, standardization and improvement of the efficiency of diagnostic procedures will be necessary in common clinical practice. Recently, minimal residual cancer cell research, such as circulating tumor cells in the peripheral blood and disseminated tumor cells in the bone marrow, has made good progress. As research in this field continues, it is expected that the mechanism of metastasis and novel therapeutic strategies targeting minimal residual cancer cells will become better understood.


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