title: Resectable left lower lobe non-small cell lung cancer with lymph node metastasis is related to unfavorable outcomes.
abstract: BACKGROUND
  Despite numerous previous studies, the consideration of tumor location as a prognostic factor in resectable non-small cell lung cancer (NSCLC) remains controversial. The present study analyzed the association between tumor location and clinical outcome in patients with resectable NSCLC who had undergone lobectomy with systematic lymphadenectomy and who had presented with varying nodal statuses.
  
  
  METHODS
  The data from a cohort of 627 eligible patients treated in Sun Yat-sen University Cancer Center between January 2000 and December 2008 were retrospectively collected, and the nodal statuses of patients with different tumor locations were compared. Cox proportional hazards regression model was used to determine the independent factors related to cancer-specific survival (CSS).
  
  
  RESULTS
  Multivariate analysis demonstrated that left lower lobe (LLL) tumors [hazard ratio (HR): 1.465, 95% confidence interval (CI) 1.090-1.969, P = 0.011], lymph node metastasis (HR: 2.742, 95% CI 2.145-3.507, P < 0.001), and a tumor size of >4 cm (HR: 1.474, 95% CI 1.151-1.888, P = 0.002) were three independent prognosticators in patients with resectable NSCLC. However, LLL tumors were associated only with CSS in node-positive patients (HR: 1.528, 95% CI 1.015-2.301, P = 0.042), and a tumor size of >4 cm was the only independent risk predictor in the node-negative subgroup (HR: 1.889, 95% CI 1.324-2.696, P < 0.001).
  
  
  CONCLUSIONS
  Tumor location is related to the long-term CSS of NSCLC patients with lymph node metastasis. LLL tumors may be upstaged in node-positive patients to facilitate an optimal treatment strategy.
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P.R. China. yewenfeng2015@126.com.|Department of Clinical Nutrition, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P.R. China. yewenfeng2015@126.com.
authors.forename: Wen-Feng
authors.initials: WF
authors.lastname: Ye
authors.affiliation: Department of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, P.R. China. panqie2891@sina.com.
authors.forename: Xuan
authors.initials: X
authors.lastname: Xie
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P.R. China. yanghong@sysucc.org.cn.|Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. yanghong@sysucc.org.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P.R. China. luokj@sysucc.org.cn.|Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. luokj@sysucc.org.cn.
authors.forename: Kong-Jia
authors.initials: KJ
authors.lastname: Luo
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P.R. China. liuqw@sysucc.org.cn.|Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. liuqw@sysucc.org.cn.
authors.forename: Qian-Wen
authors.initials: QW
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P.R. China. liuqw@sysucc.org.cn.|Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. liuqw@sysucc.org.cn.
authors.forename: Yu-Zhen
authors.initials: YZ
authors.lastname: Zheng
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P.R. China. wangjy@sysucc.org.cn.|Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. wangjy@sysucc.org.cn.
authors.forename: Jun-Ye
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013908:Thoracotomy; D016896:Treatment Outcome; D055815:Young Adult