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. 2014 Feb;47(1):13-9.
doi: 10.5090/kjtcs.2014.47.1.13. Epub 2014 Feb 5.

The Prognosis According to Patterns of Mediastinal Lymph Node Metastasis in Pathologic Stage IIIA/N2 Non-Small Cell Lung Cancer

Do Wan Kim  1 , Ju Sik Yun  1 , Sang Yun Song  1 , Kook Joo Na  1
Affiliations

The Prognosis According to Patterns of Mediastinal Lymph Node Metastasis in Pathologic Stage IIIA/N2 Non-Small Cell Lung Cancer

Do Wan Kim et al. Korean J Thorac Cardiovasc Surg. 2014 Feb.

Abstract

Background: The aim of this study is to evaluate prognostic factors for survival in pathologic stage IIIA/N2 non-small-cell lung cancer (NSCLC), to identify the prognostic significance of the metastatic patterns of mediastinal lymph nodes (MLNs) relating to survival and to recurrence and metastasis.

Methods: A total of 129 patients who underwent radical resection for pathologic stage IIIA-N2 NSCLC from July 1998 to April 2011 were retrospectively reviewed. The end points of this study were rates of loco-regional recurrence and distant metastasis, and survival.

Results: The overall 5-year survival rate was 47.4%. A univariate analysis showed that age, pathologic T stage, and adjuvant chemotherapy were significant prognostic factors, while in multivariate analysis, pathologic T stage and adjuvant chemotherapy were significant prognostic factors. The metastasis rate was higher in patients with multistation N2 involvement and with more than 3 positive MLNs. Further, non-regional MLN metastasis was associated with a higher loco-regional recurrence rate.

Conclusion: Pathologic T stage and adjuvant chemotherapy were independent prognostic factors for long-term survival in pathologic stage IIIA/N2 NSCLC. The recurrence and the metastasis rate were affected by the metastatic patterns of MLNs. These results may be helpful for planning postoperative therapeutic strategies and predicting outcomes.

Keywords: Carcinoma, non-small cell, lung; Lung surgery; Mediastinal lymph nodes; Neoplasm metastasis.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Survival curve according to (A) age, (B) pathologic T stage, and (C) postoperative (adjuvant) therapy.
Fig. 2
Fig. 2
Survival curve of patients with upper lobe cancer according to regional metastases.
Fig. 3
Fig. 3
Survival curve of patients with positive highest mediastinal lymph node according to (postoperative) adjuvant treatment (chemotherapy or combined therapy).
See this image and copyright information in PMC

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