The prognosis according to patterns of mediastinal lymph node metastasis in pathologic stage IIIA/N2 non-small cell lung cancer

  • Author: Do Wan Kim, Ju Sik Yun, Sang Yun Song, Kook Joo Na
  • Date: 2014/02/05
  • Journal: Journal of Chest Surgery;47(1);13-19
  • PMID: 24570860
  • PMCID: PMC3928257

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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