- 作者：Masaoki Ito ; Yoshinori Yamashita ; Yasuhiro Tsutani ; Keizo Misumi ; Hiroaki Harada ; Yoshihiro Miyata ; Morihito Okada
- 关键词：Lymph node ; Non&ndash ; small-cell lung cancer ; N2 disease ; Prognosis ; Tumor staging
- 刊名：Clinical Lung Cancer
- 出版年：November, 2013
- 年：2013
- 卷：14
- 期：6
- 页码：651-657
- 全文大小：739 K
Background
Subdivisions of N2 non-small-cell lung cancer (NSCLC) cases based on metastatic status of mediastinal and non-mediastinal lymph nodes have been proposed. This study aimed to evaluate N2 disease classification by mediastinal lymph nodes alone.Patients and Methods
We reviewed 187 patients with NSCLC pN1-N2 who were surgically treated to evaluate the proposed classifications: number, rate, nodal zone of metastatic lymph nodes. We evaluated N2 disease classification based on mediastinal lymph nodes alone in 136 pN2 cases.
Results
The number (1-2, 3-5, and 6鈮? or rate (15%鈮? 15%< to 40%>, and 40%鈮? classification based on all metastatic lymph nodes was validated by the log-rank test and Cox proportional hazards model. After reclassification by number or rate of metastatic mediastinal lymph nodes alone, a significant difference was maintained among all groups except between the 3-5 and 6鈮?groups. The 5-year survival rates of the 1-2, 3-5, and 6鈮?groups were 63.4%, 32.4%, and 18.2%, respectively (1-2 vs. 3-5, P聽= .015; 3-5 vs. 6鈮? P聽= .134). With rate classification, the 5-year survival rates of the 15%鈮? 15%-40% (15%< to 40%>), and 40%鈮?groups were 56.0%, 27.3%, and 5.04%, respectively (15%鈮?vs. 15%-40%, P聽= .011; 15-40% vs. 40%鈮? P聽= .011). The Spearman's rank correlation coefficient showed a highly significant correlation of metastatic status between mediastinal lymph nodes and all lymph nodes (both P聽< .001).
Conclusion
Classification by number and rate of mediastinal lymph nodes alone enabled subdivision of N2 NSCLC cases. Metastatic status of mediastinal lymph nodes reflects that of all lymph nodes and is prognostic indicators.