Changhoon Yoo1, Shinkyo Yoon1, Dae Ho Lee1, Seung-Il Park2, Dong Kwan Kim2, Yong-Hee Kim2, Hyeong Ryul Kim2, Se Hoon Choi2, Woo Sung Kim3, Chang-Min Choi4, Se Jin Jang5, Si Yeol Song6, Su Ssan Kim6, Eun Kyung Choi6, Jae Cheol Lee1, Cheolwon Suh1, Jung-Shin Lee1, Sang-We Kim7. 1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 4. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 5. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 6. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 7. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: swkim@amc.seoul.kr.
Abstract
UNLABELLED: Stage IIIA-N2 non-small cell lung cancer (NSCLC) shows prognostic heterogeneity. We investigated the prognostic relevance of the number of metastatic pN2 nodes in patients with IIIA-N2 NSCLC. The criteria for the number of pN2 used in this study were significantly associated with the survival outcomes after surgery and may improve the accuracy of prognostic prediction in this subgroup of patients. INTRODUCTION: There have been controversies regarding the prognostic relevance of the number of positive N2 nodes in pathologic stage IIIA-N2 non-small-cell lung cancer (NSCLC). We examine prognosis of patients with pathologic stage IIIA-N2 with classifying the number of positive N2 nodes into subgroups. METHODS: From January 1997 to December 2004, 250 patients were diagnosed with pathologic stage IIIA-N2 disease. All patients underwent mediastinal lymph node dissection. After excluding 44 patients with preoperative chemotherapy, incomplete resection, and postsurgical mortality, 206 patients were included in the analysis. Patients were classified according to the number of positive N2 lymph nodes (N2a: 1 [n = 83], N2b: 2-4 [n = 82], N2c: ≥ 5 [n = 41]), and its correlation with survival outcomes were investigated. RESULTS: With a median follow-up of 96.3 months, 5-year disease-free survival (DFS) was 27.2% (95% confidence interval [CI], 21.6-33.7), and 5-year overall survival (OS) was 37.7% (95% CI, 31.5-44.7) in all patients. The number of metastatic N2 lymph nodes was associated with DFS (P < .001) and OS (P = .01). In the N2a, N2b, and N2c groups, 5-year DFS rates were 38%, 24%, and 5%, respectively, and 5-year OS rates were 47%, 35%, and 24%, respectively. In a multivariate analysis, the number of metastatic N2 lymph nodes was an independent prognostic factor for DFS and OS. CONCLUSION: Stratification of patients according to the number of metastatic N2 lymph nodes may improve the accuracy of prognostic prediction among patients with curatively resected stage IIIA-N2 NSCLC.
UNLABELLED: Stage IIIA-N2 non-small cell lung cancer (NSCLC) shows prognostic heterogeneity. We investigated the prognostic relevance of the number of metastatic pN2 nodes in patients with IIIA-N2 NSCLC. The criteria for the number of pN2 used in this study were significantly associated with the survival outcomes after surgery and may improve the accuracy of prognostic prediction in this subgroup of patients. INTRODUCTION: There have been controversies regarding the prognostic relevance of the number of positive N2 nodes in pathologic stage IIIA-N2 non-small-cell lung cancer (NSCLC). We examine prognosis of patients with pathologic stage IIIA-N2 with classifying the number of positive N2 nodes into subgroups. METHODS: From January 1997 to December 2004, 250 patients were diagnosed with pathologic stage IIIA-N2 disease. All patients underwent mediastinal lymph node dissection. After excluding 44 patients with preoperative chemotherapy, incomplete resection, and postsurgical mortality, 206 patients were included in the analysis. Patients were classified according to the number of positive N2 lymph nodes (N2a: 1 [n = 83], N2b: 2-4 [n = 82], N2c: ≥ 5 [n = 41]), and its correlation with survival outcomes were investigated. RESULTS: With a median follow-up of 96.3 months, 5-year disease-free survival (DFS) was 27.2% (95% confidence interval [CI], 21.6-33.7), and 5-year overall survival (OS) was 37.7% (95% CI, 31.5-44.7) in all patients. The number of metastatic N2 lymph nodes was associated with DFS (P < .001) and OS (P = .01). In the N2a, N2b, and N2c groups, 5-year DFS rates were 38%, 24%, and 5%, respectively, and 5-year OS rates were 47%, 35%, and 24%, respectively. In a multivariate analysis, the number of metastatic N2 lymph nodes was an independent prognostic factor for DFS and OS. CONCLUSION: Stratification of patients according to the number of metastatic N2 lymph nodes may improve the accuracy of prognostic prediction among patients with curatively resected stage IIIA-N2 NSCLC.
Authors: José Ramón Jarabo Sarceda; Sergio Bolufer Nadal; Roberto Mongil Poce; Pedro López de Castro; Ramón Moreno Balsalobre; Juan Carlos Peñalver Cuesta; Raul Embún Flor; Joaquín Pac Ferrer; Francisco Javier Algar Algar; Antonio Pablo Gámez García; Marcelo F Jiménez; Jesús Gabriel Sales-Badía; Eva Pereira; Bartomeu Massuti; Mariano Provencio; Florentino Hernando Trancho Journal: Transl Lung Cancer Res Date: 2021-04
Authors: Qiongjie Yu; Xuedan Du; Zhen Fang; Xiaolu Mao; Jinting Wu; Bin Wang; Wenfeng Li Journal: Cancer Manag Res Date: 2021-11-18 Impact factor: 3.989