Xác định các yếu tố liên quan khả năng di căn hạch và kết quả vét hạch qua nội soi lồng ngực trong phẫu thuật điều trị ung thư phổi không tế bào nhỏ

Abstract

Objective: To identify factors related to ability of lymph node metastasis and VATS lymphadenetomy in the treatment of non-small cell lung cancer. Subject and method: Prospective, longitudinal description,  109 cases of non-small cell lung cancer were treated by VATS lobectomy and lymphadenectomy at University Medical Center Ho Chi Minh city and Pham Ngoc Thach Hospital from January 1^st 2012 to December 31^st 2016. Result: An average age of 59.18 ± 10.08 (31 - 80), of which 59 males (54.1%), 50 females (45.9%). The average lung tumor size was 3.23 ± 0.91 (1.2 - 5cm). A total of 419 nodal stations examined by surgery show that there were 309 positive lymph node stations and 110 negative lymph node stations. The locations of lymph nodule and the potential of metastasis (p=0.112), the number of lymph nodule removed at each lymph node station and the probability of metastasis (p<0.001), lymph node size and the potential of metastasis (p<0.001). The locations of the lung tumors and metastasis of the lymph nodule (p>0.05), lung tumor size and lymph node metastasis (p<0.05), metastasis of lymph nodes and histopathology (p>0.05), tumor differentiation (p<0.05). The rate of ability of VATS lymphadenetomy to lymph nodule found on CT scan and intraoperation is highest at bilateral 8,9 lymph node stations and lowest at 4L station. The larger lymph node size (measured on CT scan & intraoperation), the lower ability of VATS lymphadecnetomy. Conclusion: The factors related to lymph node metastasis include: Number of lymph nodule at each station, tumor size, histopathology and tumor differentiation. However, only the location of tumor is not related. The locations and size of lymph nodule are factors related to the ability of VATS lymphadenectomy.