title: [Prognostic analysis of patients with unsuspected pathologic N1 non-small cell lung cancer].
abstract: OBJECTIVE
  To investigate the prognosis of patients with N1 non-small cell lung cancer, and to compare the clinicopathological features and survival between patients with unexpected N1 (cN0-pN1) and expected N1 disease (cN1-pN1) after operation for non-small cell lung cancer.
  
  
  METHODS
  This study retrospectively reviewed and analyzed the medical records of 183 patients who underwent surgery and pathologically diagnosed with N1 non-small cell lung cancer between January 2006 and December 2010. Among them, 78 patients had negative findings before surgery (cN0-pN1 group), and 105 patients had positive findings before surgery (cN1-pN1 group). The clinicopathological features, median survival time and 5-year survival rates between the two groups were analyzed.
  
  
  RESULTS
  Patients in the cN1-pN1 group had greater pathologic T stage, larger tumors, greater number and stations of positive N1 lymph nodes, and greater percentage of pneumonectomy than those in the cN0-pN1 group (P < 0.05). For the patients with cN0-pN1, the MST was 47.0 months and the 1-, 3-, and 5-year OS were 85.9%, 57.4%, and 42.5%, respectively. For the patients with cN1-pN1, the MST was 30.0 months and the 1-, 3-, and 5-year OS were 74.3%, 44.6%, and 28.8%, respectively. There were significant differences in survival between the two groups (P < 0.05). The locoregional recurrence rate of cN0-pN1 group was lower than in the cN1-pN1group (P < 0.05). The multivariate analysis showed that T staging and N staging before surgery, lymph node metastasis to multiple N1 stations and adjuvant chemotherapy were independent prognostic factors.
  
  
  CONCLUSIONS
  Different clinical features of N1 non-small cell lung cancer has certain heterogeneity. Patients with unexpected N1 disease show better survival and lower locoregional recurrence rate than did those with expected N1 disease.
authors.affiliation: Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230000, China.
authors.forename: Mingran
authors.initials: M
authors.lastname: Xie
authors.affiliation: Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230000, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Mei
authors.affiliation: Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230000, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230000, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230000, China.
authors.forename: Shibin
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230000, China; Email: madongchun163@163.com.
authors.forename: Dongchun
authors.initials: D
authors.lastname: Ma
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate