Abstract
PurposeThis study investigated whether the number of involved lymph nodes is associated with the prognosis in patients that underwent surgery for pathological stage (p-stage) III/N2 NSCLC.SubjectsThis study evaluated 121 patients with p-stage III/N2 NSCLC.ResultsThe histological types included 65 adenocarcinomas, 39 squamous cell carcinomas and 17 others. The average number of dissected lymph nodes was 23.8 (range: 6-55). The average number of involved lymph nodes was 5.9 (range: 1-23). The 5-year survival rate of the patients was 51.0% for single lymph node positive, 58.9% for 2 lymph nodes positive, 34.2% for 3 lymph nodes positive, and 30.0% for 4 lymph nodes positive, and 20.4% for more than 5 lymph nodes positive. The patients with either single or 2 lymph nodes positive had a significantly more favorable prognosis than the patients with more than 5 lymph nodes positive. A multivariate analysis revealed that the number of involved lymph nodes was a significant independent prognostic factor.ConclusionSurgery appears to be preferable as a one arm of multimodality therapy in p-stage III/N2 patients with single or 2 involved lymph nodes. The optimal incorporation of surgery into the multimodality approach therefore requires further clinical investigation.
Highlights
More than 1.6 million new cases of lung cancer are diagnosed worldwide each year, causing approximately 1.3 million deaths annually and representing the highest mortality rate in comparison to any other major malignancies [1,2]
A surgical resection remains the mainstay for patients with early stage non-small cell carcinoma (NSCLC) [3]
It is necessary to establish a treatment strategy to improve their prognosis of pathological stage (p-stage) III/N2 patients
Summary
More than 1.6 million new cases of lung cancer are diagnosed worldwide each year, causing approximately 1.3 million deaths annually and representing the highest mortality rate in comparison to any other major malignancies [1,2]. A careful staging workup is very important to determine the optimal treatment strategy. It is necessary to establish a treatment strategy to improve their prognosis of pathological stage (p-stage) III/N2 patients. The results of surgical treatment as a multimodality therapy for pathological stage III are not satisfactory, because the 5-year survival rates range from 20 to 30% [9,10]. The range in the survival of stage III NSCLC associated with various prognostic factors suggests that patients at the N2 stage are a heterogeneous group [11,12]. This study retrospectively investigated whether the number of involved lymph nodes is associated with prognosis in patients that underwent surgery for p-stage III-N2 NSCLC. Identifying patients who receive survival benefit from surgical resection will positively contribute to determining the optimal treatment strategies
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