WHAT KIND OF HILAR LUNG-CANCER CAN BE A CANDIDATE FOR SEGMENTECTOMY WITH CURATIVE INTENT - RETROSPECTIVE CLINICOPATHOLOGICAL STUDY OF COMPLETELY RESECTED ROENTGENOGRAPHICALLY OCCULT BRONCHOGENIC SQUAMOUS-CELL CARCINOMA

Although a randomized control trial demonstrated that limited surgery for small peripheral lung cancers was not as curative as lobectomy, th ere have been no reports concerning segmentectomy for small hilar lung cancers. In this study, we analyzed the clinicopathological features of roentgenographically occult bronchogenic squamous cell carcinomas i n order to select candidates for limited resection with curative inten t. From April 1982 through June 1995, 105 roentgenographically occult bronchogenic squamous cell carcinomas whose proximal edge of the lesio n was more peripheral than the orifice of the segmental bronchus were completely resected. The bronchoscopic findings of the lesions were cl assified into three categories: remarkable, minute and hidden. Moreove r, in terms of the range of endoscopic visibility, the lesions were cl assified into two categories: lesions within the range of endoscopic v isibility and those beyond it. If lymph nodes show no signs of metasta sis, roentgenographically occult bronchogenic squamous cell carcinoma is regarded as localized carcinoma and can be a candidate for segmente ctomy with curative intent. In cases with minute or hidden bronchoscop ic findings or of lesions within the range of endoscopic visibility, m etastatic lymph nodes were never observed. Accordingly, roentgenograph ically occult bronchogenic squamous cell carcinomas with minute or hid den bronchoscopic findings or those within the range of endoscopic vis ibility can be candidates for curative segmentectomy. (C) 1998 Elsevie r Science Ireland Ltd. All rights reserved.