Outcomes of the Initial Surgical Treatment without Neoadjuvant Therapy in Patients with Unexpected N2 Non-small Cell Lung Cancer.
- Author:
Man Shik SHIM
1
;
Jhin Gook KIM
;
Yoo Sang YOON
;
Sung Wook CHANG
;
Hong Kwan KIM
;
Yong Soo CHOI
;
Kwhan Mien KIM
;
Young Mog SHIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. jkimsmc@skku.edu
- Publication Type:Original Article
- Keywords:
Lung neoplasm;
Mediastinoscopy;
Treatment outcome;
Lung surgery;
Neoplasm staging
- MeSH:
Adenocarcinoma;
Biopsy;
Carcinoma, Non-Small-Cell Lung;
Carcinoma, Squamous Cell;
Follow-Up Studies;
Humans;
Lung Neoplasms;
Lymph Nodes;
Mediastinoscopy;
Medical Records;
Neoadjuvant Therapy;
Neoplasm Metastasis;
Neoplasm Staging;
Recurrence;
Retrospective Studies;
Survival Rate;
Treatment Outcome
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2010;43(1):39-46
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Preoperative chemotherapy has been adopted in our hospital as a standard treatment for non-small cell lung cancer patients with N2 disease. However, there have been cases of pathologic N2 disease that have been detected after curative-intent surgical resection. We retrospectively studied the outcomes of initial surgical treatment without neoadjuvant therapy in patients with unexpected N2 non-small cell lung cancer. MATERIAL AND METHOD: Between January 1995 and June 2007, 225 patients were diagnosed with pathologic N2 disease after they underwent initial pulmonary resection without neoadjuvant therapy. Among them, 170 patients were preoperatively diagnosed with lymph node stage N0 or N1. We retrospectively reviewed their medical record and analyzed the outcomes. RESULT: The overall 5-year survival rate was 35.4%. The prognostic factors that were significantly associated with survival were no adjuvant therapy, histologic cell types other than adenocarcinoma or squamous cell carcinoma, a pathologic T stage more than T1, old age (> or =70 years) and no mediastinoscopic biopsy. During the follow-up, 79 patients (46.5%) experienced tumor recurrence, including loco-regional recurrence in 20 patients (25.3%) and distant metastasis in 56 (70.9%). The 5-year recurrence-free survival rate was 33.7%. CONCLUSION: Based on our findings, the survival was good for patients with unexpected N2 non-small cell lung cancer and who underwent initial pulmonary resection without neoadjuvant therapy. A prospective comparative analysis is needed to obtain more conclusive and persuasive results.
