Survival Impact of Stations of Pathological Lymph Nodes in N2 Non-small Cell Lung Cancer in a French Hospital

Ann Surg Oncol. 2018 May;25(5):1262-1268. doi: 10.1245/s10434-018-6373-1. Epub 2018 Feb 14.

Abstract

Background: The prognosis of lung cancer remains poor; only 20% of patients can undergo surgery. N2 non-small cell lung cancer (NSCLC) is a heterogeneous disease. We conducted a retrospective study to analyze the impact of N2 location on survival.

Methods: This study included 342 NSCLC with N2 involvement between 1988 and 2014. Patient-related data were collected through the CRB biobank and included demographic, therapeutic, and survival data. Survival was analyzed according to Kaplan-Maier method. Cox's regression analysis and analysis of variance (ANOVA) were used to determine factors significantly associated with survival.

Results: The population average age was 61.6 years; 82.2% were men, a majority were former smokers (87.1%), and 45.3% had adenocarcinoma. The main prognostic factors were male gender (p = 0.01), number of nodes (p < 0.0001), and tumor size (p < 0.0001). N2 disease had a poor survival (16 months) compared with N0 (32 months) and N1 (21.1 months) disease (p < 0.0001). The patients with involvement of station 4 (survival = 17.8 months) seemed to have a prognosis between those with station 7 (survival = 10.5 months) and N1 (survival = 22.6 months), p = 0.0005.

Conclusions: N2 location has a prognostic impact in surgically NSCLC, and station 4 involvement has a better prognostic than station 7.

MeSH terms

  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Vessels / pathology
  • Carcinoma, Non-Small-Cell Lung / secondary*
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • France
  • Hospitals
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Mediastinum
  • Middle Aged
  • Neoplasm Invasiveness
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Sex Factors
  • Survival Rate
  • Tobacco Smoking
  • Trachea
  • Tumor Burden