title: [A clinical study for improving the survival rate of pN2 lung cancer through our case of 53 patients].
abstract: BACKGROUND
  In management of non-small cell lung cancer, the evaluation and treatment of N2 disease has a lot of controversy.
  
  
  METHODS
  Between 1983 and 1998, 53 patients of pN2 non-small cell lung cancer were operated by standard lymph node dissection method (R2) using CUSA system. We studied the sensitivity of the diagnosis of preoperative N factor, survival rate, and analysed the relationship between the postoperative mediastinal lymph node metastasis and the site of recurrence.
  
  
  RESULTS
  Three-year and five-year survival rates for 53 cases were 46.8% and 33.4% respectivery. Preoperative sensitivity of CT scan for N factors were only 45% in squamous cell carcinoma and 24.2% in adenocarcinoma. Even with intraoperative findings, the sensitivity was not better. In a follow up survey, ipsilateral mediastinal lymph node recurrence was not detected, contralateral mediastinal lymph node recurrences were rare and the distant metastases were common cause of death.
  
  
  CONCLUSIONS
  It is more important to accomplish the standard lymph node dissection completely in all cN cases than to evaluate the preoperative node stage aggressively using invasive methods.
authors.affiliation: Second Department of Surgery, Yamanashi Medical University, Japan.
authors.forename: W
authors.initials: W
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Okuwaki
authors.forename: S
authors.initials: S
authors.lastname: Yoshii
authors.forename: Y
authors.initials: Y
authors.lastname: Tada
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate