Nodal Station as a Prognostic Factor in Resected Stage IIIA N2 Non-Small Cell Lung Cancer.
- Author:
Dae Joon KIM
1
;
Kil Dong KIM
;
Chi Young KIM
;
Kyung Young CHUNG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea. kychu@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Neoplasm staging;
Carcinoma, non-small cell, lung;
Lymph node
- MeSH:
Carcinoma, Non-Small-Cell Lung*;
Drug Therapy;
Humans;
Lymph Nodes;
Mortality;
Neoplasm Staging;
Pneumonectomy;
Proportional Hazards Models;
Radiotherapy
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2003;36(7):489-496
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: To clarify the prognostic implication of the location and number of the metastatic mediastinal nodes in resected stage IIIA N2 non-small cell lung cancer. MATERIAL AND METHOD: One hundred and seventy-four patients with resected non-small cell lung cancer who eventually proved to have pathologic stage IIIA N2 disease were studied. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded from this study. RESULT: In upper lobe tumors, there was no difference in 5-year survival according to the involvement of lower mediastinal nodes (32.3% vs 25.6%, p=0.86). In lower lobe tumors, no differencee was found in 5-year survival according to the involvement of upper mediastinal nodes (25.1% vs 14.1%, p=0.33). There was no significant difference in 5-year survival between patients with or without metastatic subcarinal node (20.9% vs 25.6%, p=0.364). In terms of the number of metastatic mediastinal nodes, 5-year survival was better in single station group (26.3%) than multiple station group (18.3%) (p=0.048). In multiple station N2 group, the patients who received postoperative chemotherapy and radiation therapy had better 5-year survival (34.2%) (p=0.01). Cox's proportional hazards model revealed that the age > or =60 (O.R: 1.682, p=.006), multiple station N2 (O.R: 1.503. p=0.021), pneumonectomy (O.R: 1.562, p=0.018), postoperative chemotherapy and radiation therapy (O.R: 0.625, p=0.012) were the factors affecting the postoperative survival. CONCLUSION: Multiple station N2 disease was the important prognostic factor for postoperative survival in resected stage IIIA N2 non-small cell lung cancer. Postoperative chemotherapy and radiotherapy were thought to improve the survival in case of multiple station N2 disease.
