Prognostic Factors in Patients with Pathologic T1-2N1M0 Disease in Non-small Cell Carcinoma of the Lung

Abstract

Patients with stage II non-small cell lung carcinoma (NSCLC) represent a heterogeneous subgroup with variable 5-year survival rates. The influence of the type of lymph node involvement on survival and recurrence was investigated. A total of 128 consecutive patients who underwent complete tumor resection and mediastinal lymph nodes dissection for pT1-2N1M0 NSCLC between July 1991 and December 2003 were retrospectively reviewed. The overall 5-year survival of patients with T1-2N1M0 disease was 42.2%. Although pT status, histology, surgical procedure, and adjuvant therapy did not affect survival for pT1-2N1M0 patients, the 5-year survival rate differed significantly according to the type of lymph node involvement. The 5-year survival rate for patients with main bronchial lymph node involvement, interlobar and lobar lymph node involvement, and segmental bronchial lymph node involvement was 19.7%, 39.8%, and 59.7%, respectively. The survival curves of these three groups had significant differences. Fifty-five patients had cancer recurrence, and the type of lymph node involvement did not affect the pattern of cancer relapse. In patients with stage II NSCLC, survival differs according to the type of lymph node involvement: patients with only segmental lymph node involvement have a better prognosis and the disease seems to be at an early stage, whereas patients with main bronchial lymph node involvement have a poorer prognosis, and main bronchial lymph node involvement represents more advanced disease. Patients with pN1 disease represent a heterogeneous group that may be subdivided according to the level of the involved N1 station, not pT factor.