Long-term survivors with pN2 non-small cell lung cancer after a complete resection with a systematic mediastinal node dissection

Tokujiro Yano, Yasuro Fukuyama, Hideki Yokoyama, Shinji Kuninaka, Yasuhiro Terazaki, Tadashi Uehara, Hiroshi Asoh, Yukito Ichinose

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19 Citations (Scopus)


Objective: A substantial number of surgical patients with pN2 disease have survived longer than 5 years without any evidence of recurrence, although the surgical indications for those patients remain controversial. The present study was performed in order to clarify the clinical characteristics of the long-term survivors with pN2 disease. Methods: We retrospectively reviewed the cases of 111 patients with pN2 disease who had undergone a complete resection with a systematic mediastinal lymph node dissection from 1974 through 1991. Results: Of the 111 patients with pN2 disease, 20 survived longer than 5 years after a surgical resection. When both the pre- and postoperative conditions were compared between the long- term survivors and the others, the long-term survivors were characterized by significantly higher proportions of cN0 disease (P = 0.031), pT1 disease (P = 0.004), skip metastasis without hilar node metastasis (P = 0.028), and metastasis of a single mediastinal station (0.044). Of those characteristics, only the likelihood of having cN0 disease could be pre-operatively determined. The survival rate of such a population with cN0-pN2 disease was 34.5% at 5 years and 29.6% at 10 years after a complete resection, respectively. Conclusions: Pathologic N2 patients with some favorable prognostic factors can survive long-term after a complete resection combined with a systematic mediastinal lymph node dissection. At present, due to the lack of any effective adjuvant therapy, a systematic mediastinal node dissection should be routinely performed even in patients with cNO disease.

Original languageEnglish
Pages (from-to)152-155
Number of pages4
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number2
Publication statusPublished - 1998 Aug 1



  • Long-term survivors
  • Non-small cell lung cancer
  • Systematic mediastinal node dissection
  • cNO-pN2 disease
  • pN2-disease

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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