title: Survival of patients with non-small cell lung cancer according to lymph node disease: single pN1 vs multiple pN1 vs single unsuspected pN2.
abstract: OBJECTIVE
  This study was designed to describe the characteristics and survival of NSCLC patients treated with surgery and single pN1 disease, multiple pN1, and single unsuspected pN2.
  
  
  METHODS
  In 2005-2009, we treated 378 lung cancer patients with surgery with radical intent; 152 cases were pN1 or pN2. We excluded patients with neoadjuvant treatment, incomplete resection, incomplete lymph node dissection, metastasis, cN2 disease, multiple pN2, SCLC, and lack of PET-CT. All patients were staged with TNM 2010. We included 72 patients: 21 single pN1, 26 multiple pN1, and 25 single unsuspected pN2. Statistical analysis included descriptive statistics, chi-square test, Kaplan-Meier, log-rank test, and Cox proportional hazard model.
  
  
  RESULTS
  The sample included 62 men (86 %) and 10 women (14 %), mean age 64 ± 9 years. The three subgroups did not show statistically significant differences in the main characteristics. Adjuvant treatment was performed in 56 patients (78 %). The 5 year overall survival (OS) for single pN1 was 73 %; for multiple pN1, 34 %; and for single unsuspected pN2, 25 % (P = 0.15). The mean OS for single pN1 was 63 ± 6 months; median OS for multiple pN1 was 45 (range, 42-48) months and for single pN2 was 54 (range, 32-77) months. Multivariate analysis found the following negative prognostic factors of OS: for single pN1, age, female sex, and microscopic intratumoral lymphatic and vascular invasion; for multiple pN1, ≤10 lymph nodes resected.
  
  
  CONCLUSIONS
  Patients with single pN1 had better OS than patients with multiple pN1. Patients with single unsuspected pN2 had OS similar to that of multiple pN1.
authors: Department of Thoracic Surgery and University of Barcelona, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. imacia@bellvitgehospital.cat
authors: Ivan
authors: I
authors: Macia
authors: Ricard
authors: R
authors: Ramos
authors: Juan
authors: J
authors: Moya
authors: Francisco
authors: F
authors: Rivas
authors: Anna
authors: A
authors: Ureña
authors: Marta
authors: M
authors: Banque
authors: Ignacio
authors: I
authors: Escobar
authors: Gabriela
authors: G
authors: Rosado
authors: Pau
authors: P
authors: Rodriguez-Taboada
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001808:Blood Vessels / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012737:Sex Factors
chemical_list: D000970:Antineoplastic Agents