Korean J Thorac Cardiovasc Surg.  2014 Feb;47(1):13-19.

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

• Kim DW
• Yun JS
• Song SY
• Na KJ

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.

Keyword

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

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Chemotherapy, Adjuvant
Humans
Lung Neoplasms
Lymph Nodes*
Multivariate Analysis
Neoplasm Metastasis*
Prognosis*
Recurrence
Retrospective Studies
Survival Rate