| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2006;132:499-506
© 2006 The American Association for Thoracic Surgery
General Thoracic Surgery |
a Division of General Thoracic Surgery, Mayo Clinic College of Medicine, Rochester, Minn
b Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, Minn
c Division of Biostatistics, Mayo Clinic College of Medicine, Rochester, Minn
Presented at the 31st Annual Meeting of the Western Thoracic Surgical Association, Victoria, British Columbia, Canada, June 22-25, 2005.
Received for publication June 25, 2005; revisions received April 12, 2006; accepted for publication April 20, 2006. * Address for reprints: Stephen D. Cassivi, MD, MSc, Division of General Thoracic Surgery, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905 (Email: cassivi.stephen{at}mayo.edu).
OBJECTIVE: N1 disease in non–small cell lung cancer represents a heterogeneous patient subgroup with a 5-year survival of approximately 40%. Few reports have evaluated the correlation between N1 disease and tumor recurrence or which subgroup of patients would most benefit from adjuvant chemotherapy.
METHODS: From 1997 through 2002, all patients with pathologic T1-4 N1 M0 non–small cell lung cancer who had a complete resection with systematic mediastinal lymphadenectomy were retrospectively analyzed and evaluated for factors associated with recurrence and long-term survival.
RESULTS: One hundred eighty patients with N1 disease were evaluated. Sixty-six (37%) patients had either locoregional recurrence (n = 39 [22%]), distant metastasis (n = 41 [23%]), or both during follow-up. Univariate analysis demonstrated that visceral pleural invasion and age were associated with locoregional recurrence, whereas visceral pleural invasion, distinct N1 metastasis (as opposed to direct N1 invasion by the primary tumor), and multistation lymph node involvement were associated with distant metastasis (P < .05). Multivariable analysis demonstrated that visceral pleural invasion, multistation N1 involvement, and distinct N1 metastasis were the only independent predisposing factors for locoregional recurrence and distant metastasis. Overall 5-year survival was 42.5%. Survival was significantly decreased by advanced pathologic T classification (P = .015), visceral pleural invasion (P < .0001), and higher tumor grade (P = .014).
CONCLUSIONS: In patients with N1-positive non–small cell lung cancer, visceral pleural invasion, multistation N1 disease, and distinct N1 metastasis are independent predictors of subsequent locoregional recurrence and distant metastasis. Advanced T classification, visceral pleural invasion, and higher tumor grade were predictors of poor survival. These patients represent a subgroup of patients with N1 disease who might benefit from additional therapy, including adjuvant chemotherapy.
This article has been cited by other articles:
|
|
 |
|
  H. Matsuguma, I. Oki, R. Nakahara, N. Ohata, S. Igarashi, K. Mori, S. Endo, and K. Yokoi Proposal of new nodal classifications for non-small-cell lung cancer based on the number and ratio of metastatic lymph nodes Eur J Cardiothorac Surg, January 1, 2012; 41(1): 19 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Yasufuku, A. Pierre, G. Darling, M. de Perrot, T. Waddell, M. Johnston, G. da Cunha Santos, W. Geddie, S. Boerner, L. W. Le, et al. A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer J. Thorac. Cardiovasc. Surg., December 1, 2011; 142(6): 1393 - 1400.e1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Casali, A. Stefani, and U. Morandi N1 non-small-cell lung cancer. A 20-year surgical experience Asian Cardiovasc Thorac Ann, June 1, 2011; 19(3-4): 217 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Wisnivesky, J. Arciniega, G. Mhango, J. Mandeli, and E. A. Halm Lymph node ratio as a prognostic factor in elderly patients with pathological N1 non-small cell lung cancer Thorax, April 1, 2011; 66(4): 287 - 293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Saynak, J. Hubbs, J. Nam, L. B. Marks, R. H. Feins, B. E. Haithcock, and N. K. Veeramachaneni Variability in Defining T1N0 Non-Small Cell Lung Cancer Impacts Locoregional Failure and Survival Ann. Thorac. Surg., November 1, 2010; 90(5): 1645 - 1650. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H. Kang, Y. J. Ra, Y. T. Kim, S.-H. Jheon, S.-w. Sung, and J. H. Kim The Impact of Multiple Metastatic Nodal Stations on Survival in Patients With Resectable N1 and N2 Nonsmall-Cell Lung Cancer Ann. Thorac. Surg., October 1, 2008; 86(4): 1092 - 1097. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Gonfiotti, E. Crocetti, A. Lopes Pegna, E. Paci, and A. Janni Prognostic Variability in Completely Resected pN1 Non-Small-Cell Lung Cancer Asian Cardiovasc Thorac Ann, October 1, 2008; 16(5): 375 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Nakagawa, N. Okumura, Y. Kokado, K. Miyoshi, T. Matsuoka, and K. Kameyama Retrospective study of patients with pathologic N1-stage II non-small cell lung cancer Interact CardioVasc Thorac Surg, August 1, 2007; 6(4): 474 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio and A. S. Bryant Predictors of Survival and Disease-Free Survival in Patients With Resected N1 Non-Small Cell Lung Cancer Ann. Thorac. Surg., July 1, 2007; 84(1): 182 - 190. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
