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Eur J Cardiothorac Surg 2001;20:350-355
© 2001 Elsevier Science NL

Proximal bronchial extension with special reference to tumor localization in non-small cell lung cancer

Murat Kara^a, Serpil Dizbay Sak^b, Diclehan Orhan^b, evket Kavukçu^a

^a Department of Thoracic Surgery, Ankara University School of Medicine, bn-i Sina Hospital, 06100 Sihhiye, Ankara, Turkey
^b Department of Pathology, Ankara University School of Medicine, 06100 Sihhiye, Ankara, Turkey

Received 19 December 2000; received in revised form 2 May 2001; accepted 15 May 2001.

Corresponding author. Güvenlik caddesi, Esenlik sokak 7/10, 06540 Aaiayranci, Ankara, Turkey. Tel.: +90-312-4670054; fax: +90-318-2252819
e-mail: muratkara66{at}hotmail.com

Objective: Surgery is the optimal treatment in patients with non-small cell lung cancer (NSCLC) and tumor-negative bronchial resection margins should be maintained for a curative resection. The epidemiology of NSCLC, including the aspects of tumor localization, has been changing during the recent decades. The aim of this study was to evaluate microscopic proximal bronchial extension with special reference to the site of the tumor. Methods: Surgical specimens of 70 NSCLC cases were examined histologically for proximal bronchial extension of the tumor. The entire bronchial tree with the tumor was extracted from the specimen and serially cut at a thickness of 5 mm in the transverse plane of the bronchus. Microscopic proximal extension of the tumor was classified as either endobronchial or peribronchial. Results: Thirty-three (47.1%) tumors had central and 37 (52.9%) had peripheral localization. Among the central and peripheral tumors, 10 (30.3%) and seven (18.9%) had microscopic proximal extension, respectively. In total, the mean length of proximal extension was 10.94±7.07 mm. The mean length of extension for peripheral tumors was 15.71±8.38 mm, significantly greater than that of central tumors, which was 7.60±3.47 mm (P=0.026). Peripheral tumors showed a significant peribronchial extension (P=0.024). Conclusions: A greater percentage of central tumors show microscopic proximal bronchial extension, whereas the length of microscopic proximal brinchial extension is significantly greater in peripheral tumors. Peripheral tumors preferentially have a peribronchial extension pattern.

Key Words: Non-small cell lung cancer • Tumor localization • Bronchial extension

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