Involvement of the #12u lymph nodes around the upper lobe bronchi in patients with lung cancer of the right middle lobe, right lower lobe, or left lower lobe

In Japan, the lymph nodes around the upper lobe bronchi, known as the #12u nodes, are not included in the nodes recommended for dissection in patients with right middle lobe carcinoma, right lon er lobe carcinoma, or left lon er lobe carcinoma. However, histologic examination has revealed involvement of these nodes in pneumonectomy patients whose carcinoma originated in the right lower lobe, We histologically examined the IS mph nodes from 152 pat ients with lung cancer to determine the incidence of involvement of the #12 u lymph nodes. These nodes were found to he involved in 14 (9.2%) of the 15 2 patients. The rate of involvement was significantly higher in those with T2-T4 disease than in those with T1 disease, and was also significantly hig her in patients with N2 disease than in those with N1 disease, There were t wo long-term survivors without recurrence, and one other patient who lived for more than 5 years before succumbing to the disease. In conclusion, to e nsure removal of all the cancer tissue, it is recommended that the #12u lym ph nodes be included in the nodes routinely dissected in patients with righ t lower lobe carcinoma, right middle lobe carcinoma, or left loner lobe car cinoma.