Prognostic analysis of patients with unsuspected pathologic N1 non-small cell lung cancer
10.3760/cma.j.issn.0253-3766.2015.05.016
- VernacularTitle:意外性 N1期非小细胞肺癌患者的预后分析
- Author:
Mingran XIE
1
;
Xinyu MEI
;
Tian LI
;
Xiaohui SUN
;
Shibin XU
;
Dongchun MA
Author Information
1. 安徽医科大学附属省立医院胸外科
- Keywords:
Carcinoma,non-small-cell lung;
Pneumonectomy;
Lymphatic metastasis;
Prognosis;
Neoplasm staging
- From:
Chinese Journal of Oncology
2015;(5):387-391
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prognosis of patients with N1 non-small cell lung cancer, and to compare the clinicopathological features and survival between patients with unexpected N1 ( cN0-pN1) and expected N1 disease ( cN1-pN1) after operation for non-small cell lung cancer.Methods This study retrospectively reviewed and analyzed the medical records of 183 patients who underwent surgery and pathologically diagnosed with N1 non-small cell lung cancer between January 2006 and December 2010. Among them, 78 patients had negative findings before surgery ( cN0-pN1 group ) , and 105 patients had positive findings before surgery ( cN1-pN1group ) .The clinicopathological features, median survival time and 5-year survival rates between the two groups were analyzed.Results Patients in the cN1-pN1 group had greater pathologic T stage, larger tumors, greater number and stations of positive N1 lymph nodes, and greater percentage of pneumonectomy than those in the cN0-pN1 group ( P<0.05) .For the patients with cN0-pN1, the MST was 47.0 months and the 1-, 3-, and 5-year OS were 85.9%, 57.4%, and 42.5%, respectively.For the patients with cN1-pN1, the MST was 30.0 months and the 1-, 3-,and 5-year OS were 74.3%, 44.6%, and 28.8%, respectively.There were significant differences in survival between the two groups ( P<0.05) .The locoregional recurrence rate of cN0-pN1 group was lower than in the cN1-pN1group ( P<0.05 ) .The multivariate analysis showed that T staging and N staging before surgery, lymph node metastasis to multiple N1 stations and adjuvant chemotherapy were independent prognostic factors. Conclusions Different clinical features of N1 non-small cell lung cancer has certain heterogeneity.Patients with unexpected N1 disease show better survival and lower locoregional recurrence rate than did those with expected N1 disease.
