A SURVEY ANALYSIS OF THORACIC SURGEONS IN TURKEY ON MEDIASTINAL INVESTIGATION OF LUNG-CANCER

A total of 59 general thoracic surgeons of 21 academically based thora cic surgery centres in Turkey were surveyed to identify the attitudes toward mediastinal investigations in patients with lung cancer. The su rgeons were asked 16 questions in five separate groups by survey quest ionnaire. Analyses of the replies were as follows: Group I: 37 (62.7%) of the respondents were working in 11 centres where > 100 patients ar e admitted or referred for lung cancer annually. More than 50 thoracot omies are performed for lung cancer annually in one third of the centr es in which 28 (47.5%) respondents work. Group II: Among the diagnosti c methods for evaluating mediastinum, surgeons most commonly used the computed tomography, mediastinoscopy, mediastinotomy and scalene lymph node biopsy. Invasive staging was done routinely by ten (16.9%) and s electively by 44 (74.6%). Group III: In patients with preoperatively h istologically proven ipsilateral mediastinal lymph node involvement, 3 9 (66.1%) were advocates of operating. When the lymph node(s) was foun d to be positive at operation, 33 of them (55.9%) gave the decision wi th respect to the number, size and presence of pericapsular invasion o f the node(s), while 24 (40.7%) decided to perform lung resection in e very situation. Group IV: All accessible mediastinal nodes were said t o be removed at thoracotomy by 37 (62.7%). Group V: Currently availabl e methods for mediastinal investigation were found to be partially suf ficient by 37 (62.7%). The most important factor in predicting postope rative survival was selected as nodal status by 27 (45.8%). It is noti ced that nearly all thoracic surgeons in Turkey perform mediastinal in vestigation preoperatively in patients with lung cancer, however, the impact of lymph node status needs to be more commonly appreciated. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.