Abstract
Background: Some studies have suggested that among all cases of lung cancer, the outcome of lung cancer located in the right middle lobe (RML) is the worst. However, with the advances in the diagnosis and treatment methods of lung cancer over the last couple of decades, we investigated whether the prognosis of primary lung cancer located in the RML still remains inferior to that of lung cancer arising from other lobes. Methods: Between July 2003 and December 2011, 505 consecutive patients with non-small cell lung cancer (NSCLC) underwent surgical resection at our institution. Of these, 32 patients (6.3%) had tumors arising from the RML. Results: The rate of incomplete resection was higher for cancer located in the RML than that for cancer arising from other lobes. Significant associations were noted between cancer located in the RML and the rate of lymph node metastasis and initial locoregional recurrence. Multivariate analysis identified lymph node metastasis and location in the RML as independent risk factors influencing the recurrence-free survival (p = 0.006), although location in the RML was not extracted as an independent risk factor influenceing the overall survival (p = 0.060). Conclusion: Despite the recent advances in the treatment of lung cancer, evaluation of complete resection revealed that the outcome of cancer located in the RML is still the worst among cancer of all the lobes. Further early diagnosis and adjuvant therapy are needed for improving the prognosis of cancer located in the RML.
Highlights
The right middle lobe (RML) is the smallest lobe of the lungs
With the advances in the diagnosis and treatment methods of lung cancer over the last couple of decades, we investigated whether the prognosis of primary lung cancer located in the RML still remains inferior to that of lung cancer arising from other lobes
Over the decades since, marked advances have been made in the diagnosis and treatment of lung cancer, and we investigated whether primary lung cancer located in the RML may still be associated with a poor prognosis
Summary
Primary lung cancer originating from the RML is much less common than that arising from the other lobes, and is estimated to account for 3.8% - 6.7% of all lung cancers [1,2,3]. Some studies have reported that among all lung cancers, cancers arising in the RML have the worst outcomes [1,2,3]. A recent report demonstrated that the outcome of cancer located in the RML was no worse than that of cancers arising from other lobes of the lung [4]. *Disclosures: The authors have no conflicts of interests to declare. *Disclosures: The authors have no conflicts of interests to declare. #Corresponding author
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