Clinical significance in the number of involved lymph nodes in patients that underwent surgery for pathological stage III-N2 non-small cell lung cancer.
OBJECTIVE
This study investigated whether the number of involved lymph nodes is associated with the prognosis in patients that underwent surgery for pathological stage (p-stage) III/N2 NSCLC.


METHODS
This study evaluated 121 patients with p-stage III/N2 NSCLC.


RESULTS
The histological types included 65 adenocarcinomas, 39 squamous cell carcinomas and 17 others. The average number of dissected lymph nodes was 23.8 (range: 6-55). The average number of involved lymph nodes was 5.9 (range: 1-23). The 5-year survival rate of the patients was 51.0% for single lymph node positive, 58.9% for 2 lymph nodes positive, 34.2% for 3 lymph nodes positive, and 30.0% for 4 lymph nodes positive, and 20.4% for more than 5 lymph nodes positive. The patients with either single or 2 lymph nodes positive had a significantly more favorable prognosis than the patients with more than 5 lymph nodes positive. A multivariate analysis revealed that the number of involved lymph nodes was a significant independent prognostic factor.


CONCLUSIONS
Surgery appears to be preferable as a one arm of multimodality therapy in p-stage III/N2 patients with single or 2 involved lymph nodes. The optimal incorporation of surgery into the multimodality approach therefore requires further clinical investigation.
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807, Japan. hanagiri@med.uoeh-u.ac.jp
Takeshi
T
Hanagiri
Masaru
M
Takenaka
Soich
S
Oka
Yoshiki
Y
Shigematsu
Yoshika
Y
Nagata
Hidehiko
H
Shimokawa
Hidetaka
H
Uramoto
Fumihiro
F
Tanaka
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D013902:Radiography, Thoracic; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome