Abstract
INTRODUCTION: Lymph node involvement seems to be the main reason of recurrence after surgical resection in patients with N1 non-small cell lung cancer.
METHODS: Patients who were treated with surgical resection with a diagnosis of N1 non-small cell lung cancer in our hospital between July 2007 and October 2014 were reviewed. Patients were analysed in terms of age, sex, stage, pathology, locoregional metastasis and survival.
RESULTS: 1742 patients had lung resection in our institution. 774 patients had N1 disease. 710 patients were male (91.7%) and 64 (8.3%) were female. 353 patients were in stage IIA, 221 in IIB and 200 in IIIA. The cumulative survival ratio was 34.8% (SD 3.6%). Average survival time was 51.56±1.47, median 44 months. The survival was better in single hilar lymph nodes than other subtypes of N1 disease. Also when we divided the groups as single and multi N1, there was a significant difference in survival (p:0.025).
CONCLUSIONS: In our study it was found that it does not effect survival whether it is a positive lobar, interlobar or segmental lymph node but having multiple N1 positive lymph nodes worsen the survival. There are many reports in literature that having more than one N1 metastasis have dismal prognosis.
On the other hand, single positive hilar lymph nodes were found to have better survival in our study. This result depends on the number 10 lymph node that was directly invaded by a central tumor. It was reported that metastases to N1 lymph nodes are associated with a poorer prognosis compared with metastases in intralobar lymph nodes or with lymph node involvement by means of direct invasion.
In conclusion, our study indicates that direct invasion of a lymph node rather than metastasis from a far one has better survival.
- Copyright ©the authors 2016