title: Mediastinal lymph-nodes metastasis beyond the lobe-specific: an independent risk factor toward worse prognoses.
abstract: OBJECTIVE
  Five-year survival rates were widely dispersed in pN2 non-small cell lung cancer (NSCLC). The present study aims to investigate the prognosis of patients with lymph node metastasis beyond lobe-specific mediastinal regions.
  
  
  METHODS
  A total of 654 pathologically proved N2-NSCLC patients were enrolled. All patients underwent a major pulmonary resection and radical mediastinal lymphadenectomy. Two separate groups were assigned according to the definition of lobe-specific nodal metastasis: Group LS (lobe-specific) and Group NLS (non-lobe-specific). Survival rates were calculated using Kaplan-Meier and Cox regression models.
  
  
  RESULTS
  There were 376 cases in Group LS and 278 cases in Group NLS. Univariate analyses showed that the risk factors of 5-year survival were operation type, MLN positivity ratio, nodal station, nodal zone, and LS/NLS metastasis. The 5-year survival among those in Group LS was significantly better than that of Group NLS (27.5% vs. 11.7%, p <0.0001). Multivariate analysis confirmed that the grouping method of LS/NLS and number of involved nodal zones were the most prominent risk factors for 5-year survival.
  
  
  CONCLUSIONS
  Lymph node metastasis beyond lobe-specific lymph nodes is an independent risk factor of 5-year survival and is associated with worse prognoses for N2 NSCLC patients.
authors.affiliation: Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Sun
authors.forename: Wen
authors.initials: W
authors.lastname: Gao
authors.forename: Hui
authors.initials: H
authors.lastname: Zheng
authors.forename: Gening
authors.initials: G
authors.lastname: Jiang
authors.forename: Chang
authors.initials: C
authors.lastname: Chen
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D011013:Pneumonectomy; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome