Original articleGeneral thoracicPrognostic Significance of Surgical-Pathologic N1 Lymph Node Involvement in Non-Small Cell Lung Cancer
Section snippets
Patients and Methods
From January 1995 to November 2006, we performed 1,616 anatomic resections in patients with NSCLC in our institution. Patients were grouped according to highest level of involved lymph node station. Of these, 862 patients (53.3%) had no nodal metastases (N0 disease), 540 (33.4%) had N1 nodal metastases (N1 disease), and 214 (13.2%) had mediastinal nodal metastases (N2 disease). We performed retrospective analysis of the pattern of lymph node metastasis and prognosis in 540 consecutive
Results
The completely resected patients had a 5-year survival rate of 50.3% with a median survival time of 63 months; incompletely resected patients had a 5-year survival rate of 19% with a median survival time of 23 months (p = 0.003; Fig 1). The 5-year survival rates of patients with squamous cell carcinoma, adenocarcinoma, and others were 50%, 51%, and 43%, respectively. Although squamous cell carcinoma tended to show a better prognosis, no significant difference was observed among the three
Comment
The accurate staging of lymph node involvement is of pivotal importance in the management of NSCLC as it aids in treatment selection and predicting outcome [2]. In patients undergoing surgery for resection of NSCLC, the assessment of nodal disease has gradually become an accepted part of the operation [2].
The latest revisions of the TNM staging system were adopted in 1997 [1]. These consisted of stage grouping by a recombination of T, N, and M factors, and redefinition of these factors. In the
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