Prognostic Variability in Completely Resected pN1 Non-Small-Cell Lung Cancer

2008 ◽  
Vol 16 (5) ◽  
pp. 375-380 ◽  
Author(s):  
Alessandro Gonfiotti ◽  
Emanuele Crocetti ◽  
Andrea Lopes Pegna ◽  
Eugenio Paci ◽  
Alberto Janni
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Small Cell Lung Cancer ◽  
Survival Rates ◽  
Lymph Node Involvement ◽  
Small Cell ◽  
Small Cell Lung ◽  
Hilar Lymph Node ◽  
Node Involvement

We used the Tuscan Cancer Registry archives to retrieve records of 2,896 patients with a histological diagnosis of lung tumor from January 1996 to December 2000. Of 2,410 patients with non-small-cell lung cancer, 767 (31.8%) underwent complete resection. The following variables were analyzed for their influence on survival in the 157 patients with pathologic N1 status: sex, age, cell type, pathologic tumor status, number and level of involved lymph nodes, tumor grade, and type of surgery. Overall 5-year survival rates were 43.9% for 417 patients with pN0 disease, 10.8% for 176 with pN2 disease, and 31.6% for those with pN1 disease. In pN1 disease, the overall 5-year survival rates for patients with hilar and non-hilar lymph node involvement were 27.4% and 39.6%, respectively. Univariate analysis demonstrated that pathological T status and level of N1 involvement weresignificant prognostic factors. Cox proportional hazards analysis indicated that hilar lymph node involvement was an independent prognostic factor. N1 lymph node status was identified as an independent prognostic factor in a combination of subgroups with different prognoses.

Survival of Patients With Resected N2 Non–Small-Cell Lung Cancer: Evidence for a Subclassification and Implications

2000 ◽  
Vol 18 (16) ◽  
pp. 2981-2989 ◽  
Author(s):  
Fabrice Andre ◽  
Dominique Grunenwald ◽  
Jean-Pierre Pignon ◽  
Antoine Dujon ◽  
Jean Louis Pujol ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Preoperative Chemotherapy ◽  
Cell Lung Cancer ◽  
Survival Rates ◽  
Lymph Node Involvement ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Involvement

PURPOSE: Patients who suffer from non–small-cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (N2) belong to a heterogeneous subgroup of patients. We analyzed the prognosis of patients with resected N2 NSCLC to propose homogeneous patient subgroups.PATIENTS AND METHODS: The present study comprised 702 consecutive patients from six French centers who underwent surgical resection of N2 NSCLC. Initially, two groups of patients were defined: patients with clinical N2 (cN2) and those with minimal N2 (mN2) disease were patients in whom N2 disease was and was not detected preoperatively at computed tomographic scan, respectively.RESULTS: The median duration of follow-up was 52 months (range, 18 to 120 months). A multivariate analysis using Cox regression identified four negative prognostic factors, namely, cN2 status (P < .0001), involvement of multiple lymph node levels (L2+; P < .0001), pT3 to T4 stage (P < .0001), and no preoperative chemotherapy (P < .01). For patients treated with primary surgery, 5-year survival rates were as follows: mN2, one level involved (mN2L1, n = 244): 34%; mN2, multiple level involvement (mN2L2+, n = 78): 11%; cN2L1 (n = 118): 8%; and cN2L2+ (n = 122): 3%. When only patients with mN2L1 disease were considered, the site of lymph node involvement according to the American Thoracic Society numbering system had no prognostic significance (P = .14). Preoperative chemotherapy was associated with a better prognosis for those with cN2 (P < .0001). Five-year survival rates were 18% and 5% for cN2 patients treated with and without preoperative chemotherapy, respectively.CONCLUSION: This study has identified homogeneous N2 NSCLC prognostic subgroups and suggests different therapeutic approaches according to the subgroup profile.

Survival and characteristics of lymph node involvement in patients with N1 non-small cell lung cancer

Lung Cancer ◽  
2004 ◽  
Vol 43 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Toshihiro Osaki ◽  
Akira Nagashima ◽  
Takashi Yoshimatsu ◽  
Yuko Tashima ◽  
Kosei Yasumoto
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lymph Node Involvement ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Involvement

The Role of Chemotherapy in the Management of Stage IIIA Non-Small Cell Lung Cancer

2013 ◽  
pp. 320-325
Author(s):  
Christina S. Baik ◽  
Eric Vallières ◽  
Renato G. Martins
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Surgical Resection ◽  
Randomized Trials ◽  
Lymph Node Involvement ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Node Involvement

Patients with confirmed stage IIIA non-small cell lung cancer (NSCLC) represent a very heterogeneous group which includes those with limited microscopic ipsilateral mediastinal lymph node involvement discovered after a surgical resection, as well as those who have radiologically evident bulky subcarinal lymph node involvement at presentation. Different therapeutic options in stage IIIA disease include neoadjuvant chemo- or chemoradiotherapy followed by surgery, primary surgery followed by adjuvant chemotherapy with or without sequential adjuvant radiation therapy or definitive chemoradiation without surgery. The roles of surgery and radiation in stage IIIA disease are controversial, and there is inadequate data from randomized trials to inform the optimal therapeutic strategy. In contrast, chemotherapy has a clear indication in the curative setting. Data from randomized trials indicates that cisplatin-based chemotherapy should be given in either adjuvant or neoadjuvant settings to patients who are undergoing curative surgical resection and who are candidates for cisplatin therapy. In definitive chemoradiotherapy, cisplatin-based therapy is recommended although a carboplatin-based regimen may be given if patients cannot receive cisplatin. Finally, all patients with stage IIIA NSCLC should be evaluated early in a multidisciplinary setting that includes medical and radiation oncologists and thoracic surgeons with experience in lung cancer therapy.

Sign in / Sign up

Export Citation Format

Share Document