title: Surgical outcome of stage IIIA- cN2/pN2 non-small-cell lung cancer patients in Japanese lung cancer registry study in 2004.
abstract: BACKGROUND
  The role of surgery in the treatment of non-small-cell lung cancer (NSCLC) with clinically manifested mediastinal node metastasis is controversial even in resectable cases because it is often accompanied by systemic micrometastasis. However, surgery is occasionally indicated for cases with single-station N2 disease or within multimodal treatment regimens, and in clinical trials. The aim of this study is to evaluate surgical outcomes in a modern cohort of patients with clinical (c-) stage IIIA-N2 NSCLC whose nodal metastasis was confirmed by pathology (cN2/pN2).
  
  
  METHODS
  From the central database of lung cancer patients undergoing surgery in 2004, which was founded by the Japanese Joint Committee for Lung Cancer Registration, data of patients having all conditions of NSCLC, c-stage IIIA, cN2, and pN2 were extracted, and the clinicopathologic profile of patients and surgical outcomes were evaluated.
  
  
  RESULTS
  Among 11,663 registered NSCLC cases, 436 patients (3.8%) (332 men and 104 women) had been extracted. Their mean age was 65 years, and histologic types included adenocarcinoma (n = 246), squamous cell carcinoma (n = 132), and others (n = 58). The proportion of R0 resection was 82.5% and the proportion of the hospital deaths among the cause of death was 2.3%. The 5-year survival rate was 30.1% for the selected group of patients. The postoperative prognosis was significantly better than those of corresponding populations extracted from the 1994 (p = 0.0001) and 1999 databases (p = 0.0411). Men and women experienced a significantly different survival outcome (p = 0.025) with 5-year survivals of 27.5% and 37.8%, respectively. Single-station N2 cases occupied 60.9 % of the cohort and showed a significantly better prognosis than multistation N2 (p = 0.0053, 35.8 % versus 22.0 % survival rate at 5 years).
  
  
  CONCLUSIONS
  The surgical outcomes of c-stage IIIA-cN2/pN2 NSCLC patients in 2004 were favorable in comparison with those ever reported.
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. iyoshino@faculty.chiba-u.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yoshida
authors.forename: Etsuo
authors.initials: E
authors.lastname: Miyaoka
authors.forename: Hisao
authors.initials: H
authors.lastname: Asamura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Fujii
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Kenji
authors.initials: K
authors.lastname: Eguchi
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
authors.forename: Kohei
authors.initials: K
authors.lastname: Yokoi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors