title: Long-term survival after complete mediastinal lymph node resection and lobectomy in patients with bulky N2 non-small cell lung cancer.
abstract: BACKGROUND
  At Juntendo University Hospital, Japan, two patients with complete resection of bulky N2 non-small cell lung cancer (NSCLC) has survived over the long term. Therefore, we decided to retrospectively study patients who also had a complete resection of the tumor including the "bulky" superior mediastinal node for the purpose of reviewing covariates that might be related to the favorable outcome.
  
  
  METHODS
  We retrospectively analyzed the relation between covariates and survival after complete lobectomy and mediastinal lymph node resection (from April 1997 to August 2007) in 15 patients with bulky N2 NSCLC, lymph nodes greater than 2 cm in short-axis diameter (bulky nodal disease) measured on preoperative chest computer tomography.
  
  
  RESULTS
  Of 15 patients, 5 with bulky N2 single station had survival after the resection. Univariate analysis revealed that the postoperative stage significantly affected overall survival (p = 0.0101). Single-station node involvement in bulky N2 disease was the covariate associated with overall survival (p = 0.0150) and disease free survival (p = 0.0052).
  
  
  CONCLUSIONS
  In the complete resection of bulky N2 NSCLC in patients with lymph nodes measuring more than 2 cm in short-axis diameter, single-station node involvement suggests a favorable outcome and long-term survival, compared to patients with multi-station involvement.
authors: Juntendo University School of Medicine, Department of General Thoracic Surgery, Tokyo, Japan. m-skrb@juntendo.ac.jp
authors: Motoki
authors: M
authors: Sakuraba
authors: Nobumasa
authors: N
authors: Takahashi
authors: Shiaki
authors: S
authors: Oh
authors: Yoshikazu
authors: Y
authors: Miyasaka
authors: Tomoya
authors: T
authors: Inagaki
authors: Kenji
authors: K
authors: Suzuki