HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (16) Citing Articles via Google Scholar Google Scholar Articles by Yoshino, I. Articles by Yasumoto, K. Search for Related Content PubMed PubMed Citation Articles by Yoshino, I. Articles by Yasumoto, K.

Unfavorable Prognosis of Patients With Stage II Non-small Cell Lung Cancer Associated With Macroscopic Nodal Metastases^*

^* From the Department of Surgery II, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

Correspondence to: Ichiro Yoshino, MD, Department of Surgery II, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1–1, Yahatanishi-ku, Kitakyushu 807, Japan; e-mail: ichiroy{at}med.uoeh-u.ac.jp

Background: Patients with stage II-N1 non-small cell lung cancer (NSCLC) make up an intermediate group of patients with an unsatisfactory prognosis even though complete resection is usually possible. We retrospectively analyzed postoperative prognostic factors to devise guidelines for the proper management of this patient population.

Study design: Among 546 patients with NSCLC who underwent surgical resection from 1979 to 1995, 43 patients were pathologically defined to be at stage II-N1 (T1–2N1M0). The influence of the following variables on postoperative survival was analyzed: gender, age, cell type, pathologic T factor, number of metastatic nodes, station of metastatic nodes (hilar or pulmonary nodes), status of nodal metastasis (macroscopic, gross involvement confirmed histologically; or microscopic, metastasis first defined by histologic examination), surgical methods, and adjuvant therapy (including 18 of chemotherapy and 2 of radiotherapy).

Results: The 5-year survival rates (5YSRs) of patients with microscopic (n = 21) and macroscopic nodal metastasis (n = 22) were 76.0% and 27.6%, respectively (p = 0.001). The 5YSRs of 20 patients who received adjuvant therapy and 23 who did not receive adjuvant therapy were 57.6% and 46.6%, respectively (p = 0.036). Other variables did not affect survival. The Cox proportional hazards model analysis indicated that the presence of a macroscopic nodal metastasis and postoperative adjuvant therapy were independent prognostic factors. Among patients with macroscopic N1 NSCLC, 9 patients who had undergone adjuvant therapy showed a more favorable prognosis than the 13 patients who had not received adjuvant therapy (3-year survival rate, 55.6% vs 18.5%; p = 0.037; and recurrence rate, 30.0% vs 77.8%), whereas no significant influence of adjuvant therapy on survival was observed among patients with microscopic N1 NSCLC.

Conclusions: Stage II-N1 NSCLC was categorized into microscopic and macroscopic N1 diseases. The latter had a poor prognosis, which might be improved by adjuvant therapy, although a suitable regimen has not been established.

Key Words: nodal metastasis • non-small cell lung cancer • TNM classification

This article has been cited by other articles:

				J. P. Wisnivesky, C. I. Henschke, and D. F. Yankelevitz Diagnostic Percutaneous Transthoracic Needle Biopsy Does Not Affect Survival in Stage I Lung Cancer Am. J. Respir. Crit. Care Med., September 15, 2006; 174(6): 684 - 688. [Abstract] [Full Text] [PDF]

				T. Fujimoto, S. D. Cassivi, P. Yang, S. A. Barnes, F. C. Nichols, C. Deschamps, M. S. Allen, and P. C. Pairolero Completely resected N1 non-small cell lung cancer: Factors affecting recurrence and long-term survival. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 499 - 506. [Abstract] [Full Text] [PDF]

				O. A. Khan, J. J. Fitzgerald, M. L. Field, I. Soomro, F. D. Beggs, W. E. Morgan, and J. P. Duffy Histological determinants of survival in completely resected T1-2N1M0 nonsmall cell cancer of the lung Ann. Thorac. Surg., April 1, 2004; 77(4): 1173 - 1178. [Abstract] [Full Text] [PDF]

				A. Marra, L. Hillejan, G. Zaboura, T. Fujimoto, D. Greschuchna, and G. Stamatis Pathologic N1 non-small cell lung cancer: Correlation between pattern of lymphatic spread and prognosis J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 543 - 553. [Abstract] [Full Text] [PDF]

				F. Tanaka, K. Yanagihara, Y. Otake, T. Yamada, T. Shoji, R. Miyahara, K. Inui, and H. Wada Prognostic factors in patients with resected pathologic (p-) T1-2N1M0 non-small cell lung cancer (NSCLC) Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 555 - 561. [Abstract] [Full Text] [PDF]

				T. Fujimoto, G. Zaboura, S. Fechner, L. Hillejan, T. Schroder, A. Marra, T. Krbek, M. Hinterthaner, D. Greschuchna, and G. Stamatis Completion pneumonectomy: Current indications, complications, and results J. Thorac. Cardiovasc. Surg., March 1, 2001; 121(3): 484 - 490. [Abstract] [Full Text] [PDF]