title: Prognostic factors in resectable pathological N2 disease of non-small cell lung cancer.
abstract: BACKGROUND
  N2-positive non-small cell lung cancer (NSCLC) exhibits extremely low survival rates. The role of surgery in operable locally advanced N2 NSCLC remains controversial. In this study, we tried to analyze the role of surgery in resectable N2 NSCLC and the relationship between survival and clinico-pathologic factors from a pathologic point of view.
  
  
  METHODS
  108 resectable pathologic N2-positive NSCLC patients, diagnosed from January 2005 to July 2012, were enrolled in this study. We retrospectively reviewed the medical records, image studies, and pathology reports to collect the clinico-pathologic factors in these patients.
  
  
  RESULTS
  Those who received lobectomy (p = 0.002) and had a metastatic lymph node ratio less than 0.4 (p = 0.01) had a better overall survival rate. In addition, our study also showed that perineural invasion may play a significant role in disease-free survival (p = 0.01) CONCLUSIONS: Metastatic lymph node ratio greater than 0.4 and non-anatomic resection were poor prognostic factors for disease-free survival. Anatomic resection for selected N2 patients may play a crucial role in the overall survival rate. Perineural invasion showed an adverse impact on disease-free survival, but further investigation is warranted.
authors.forename: Chen-Ping
authors.initials: CP
authors.lastname: Hsieh
authors.forename: Jui-Ying
authors.initials: JY
authors.lastname: Fu
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
authors.forename: Cheng-Ta
authors.initials: CT
authors.lastname: Yang
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Ching-Yang
authors.initials: CY
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000175:diagnosis* / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate