RESULTS OF SURGERY FOR BRONCHOGENIC-CARCINOMA LOCATED IN THE AORTIC WINDOW

Because of its critical location, lung cancer located in the aortic wi ndow can cause complications affecting the pulmonary artery trunk, aor tic arch and esophagus. The results of surgical treatment are poor; ho wever, there are a few long-term survivors. In an attempt to define th e indications for extended surgery, we evaluated eleven patients with non-small cell lung cancer. The tumors were classified according to th eir clinical extent of invasion as Type A (invading the anterior media stinum including the central part of the pulmonary artery), Type B (in vading upwardly to the mediastinum through the aortic window) or Type C (invading the posterior mediastinum including the thoracic aorta or esophagus). In the five patients with type A invasion, no metastases t o the upper mediastinal lymph nodes other than the subaortic lymph nod es were found. The three patients with type B invasion had many metast ases to the upper mediastinal lymph nodes. There were no metastases in the upper mediastinum in any of the these patients with type C invasi on, but metastases were found in a lower mediastinal lymph node, #9, a nd a carinal lymph node. Each group clearly demonstrated a different s ite of mediastinal lymph nodes metastasis. The long term result was go od in Type A invasion, in contrast to Type B or C invasion. Our classi fication may be useful for planning one's surgical approach to advance d lung cancer of the aortic window. (C) 1997 Elsevier Science Ireland Ltd.