Surgical outcomes after initial surgery for clinical single-station N2 non-small-cell lung cancer

Tomoyuki Hishida, Junji Yoshida, Yuichiro Ohe, Keiju Aokage, Genichiro Ishii, Kanji Nagai

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: Single-station N2 (Stage IIIA) non-small-cell lung cancer has been reported to have a relatively favorable prognosis after surgery. However, most previous studies examined surgical outcomes in N2 disease by pathologic nodal status but not by clinical nodal status. The objective of this study was to clarify the surgical outcomes in clinical single-station N2 nonsmall-cell lung cancer patients. Methods: A total of 125 consecutive patients with clinical single-station N2 non-small-cell lung cancer were treated in our institution between 1992 and 2008. Among them, 97 (78%) patients underwent thoracotomy, and were included in this retrospective study. We defined clinical single-station N2 node as a node measuring 1-2 cm in a single mediastinal station observed on contrast-enhanced computed tomography. The median follow-up period was 5.9 years (range, 1.8-12.6). Results: Eighty-eight (91%) patients underwent lung resection. Of them, 17 (19%) had true (pathologic) single-station N2 disease. Twenty-eight (32%) had pathologic multistation N2 and 43 (49%) had pN0-1 disease with favorable prognoses. The overall survival of the clinical single-station N2/pathologic N2 patients after initial surgery was unsatisfactory with a 5-year overall survival of 23.6%, but their prognoses were heterogeneous. True single-station pathologic N2 status (hazard ratio = 0.35, P = 0.008) and negative subcarinal node status (hazard ratio = 0.34, P = 0.022) were independent favorable prognostic factors after initial resection for clinical single-station N2/ pathologic N2 patients. The patients with both factors revealed a relatively favorable 5-year overall survival of 43.8%. Conclusion: Clinical single-station N2 status does not always correspond with pathologic true N2 status. From a prognostic point of view, initial surgery for clinical single-station N2 patients is indicated if their true single-station N2 status and negative subcarinal involvement are preoperatively confirmed.

Original languageEnglish
Article numberhyt164
Pages (from-to)85-92
Number of pages8
JournalJapanese Journal of Clinical Oncology
Volume44
Issue number1
DOIs
Publication statusPublished - 2014 Jan
Externally publishedYes

Fingerprint

Non-Small Cell Lung Carcinoma
Survival
Thoracotomy
Retrospective Studies
Tomography
Lung

Keywords

  • Chemoradiotherapy
  • Initial surgery
  • N2
  • Non-small-cell lung cancer
  • Single-station
  • Stage IIIA

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Radiology Nuclear Medicine and imaging

Cite this

Surgical outcomes after initial surgery for clinical single-station N2 non-small-cell lung cancer. / Hishida, Tomoyuki; Yoshida, Junji; Ohe, Yuichiro; Aokage, Keiju; Ishii, Genichiro; Nagai, Kanji.

In: Japanese Journal of Clinical Oncology, Vol. 44, No. 1, hyt164, 01.2014, p. 85-92.

Research output: Contribution to journalArticle

Hishida, Tomoyuki ; Yoshida, Junji ; Ohe, Yuichiro ; Aokage, Keiju ; Ishii, Genichiro ; Nagai, Kanji. / Surgical outcomes after initial surgery for clinical single-station N2 non-small-cell lung cancer. In: Japanese Journal of Clinical Oncology. 2014 ; Vol. 44, No. 1. pp. 85-92.
@article{3011da18fea946f39684ec193b951b77,
title = "Surgical outcomes after initial surgery for clinical single-station N2 non-small-cell lung cancer",
abstract = "Objective: Single-station N2 (Stage IIIA) non-small-cell lung cancer has been reported to have a relatively favorable prognosis after surgery. However, most previous studies examined surgical outcomes in N2 disease by pathologic nodal status but not by clinical nodal status. The objective of this study was to clarify the surgical outcomes in clinical single-station N2 nonsmall-cell lung cancer patients. Methods: A total of 125 consecutive patients with clinical single-station N2 non-small-cell lung cancer were treated in our institution between 1992 and 2008. Among them, 97 (78{\%}) patients underwent thoracotomy, and were included in this retrospective study. We defined clinical single-station N2 node as a node measuring 1-2 cm in a single mediastinal station observed on contrast-enhanced computed tomography. The median follow-up period was 5.9 years (range, 1.8-12.6). Results: Eighty-eight (91{\%}) patients underwent lung resection. Of them, 17 (19{\%}) had true (pathologic) single-station N2 disease. Twenty-eight (32{\%}) had pathologic multistation N2 and 43 (49{\%}) had pN0-1 disease with favorable prognoses. The overall survival of the clinical single-station N2/pathologic N2 patients after initial surgery was unsatisfactory with a 5-year overall survival of 23.6{\%}, but their prognoses were heterogeneous. True single-station pathologic N2 status (hazard ratio = 0.35, P = 0.008) and negative subcarinal node status (hazard ratio = 0.34, P = 0.022) were independent favorable prognostic factors after initial resection for clinical single-station N2/ pathologic N2 patients. The patients with both factors revealed a relatively favorable 5-year overall survival of 43.8{\%}. Conclusion: Clinical single-station N2 status does not always correspond with pathologic true N2 status. From a prognostic point of view, initial surgery for clinical single-station N2 patients is indicated if their true single-station N2 status and negative subcarinal involvement are preoperatively confirmed.",
keywords = "Chemoradiotherapy, Initial surgery, N2, Non-small-cell lung cancer, Single-station, Stage IIIA",
author = "Tomoyuki Hishida and Junji Yoshida and Yuichiro Ohe and Keiju Aokage and Genichiro Ishii and Kanji Nagai",
year = "2014",
month = "1",
doi = "10.1093/jjco/hyt164",
language = "English",
volume = "44",
pages = "85--92",
journal = "Japanese Journal of Clinical Oncology",
issn = "0368-2811",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Surgical outcomes after initial surgery for clinical single-station N2 non-small-cell lung cancer

AU - Hishida, Tomoyuki

AU - Yoshida, Junji

AU - Ohe, Yuichiro

AU - Aokage, Keiju

AU - Ishii, Genichiro

AU - Nagai, Kanji

PY - 2014/1

Y1 - 2014/1

N2 - Objective: Single-station N2 (Stage IIIA) non-small-cell lung cancer has been reported to have a relatively favorable prognosis after surgery. However, most previous studies examined surgical outcomes in N2 disease by pathologic nodal status but not by clinical nodal status. The objective of this study was to clarify the surgical outcomes in clinical single-station N2 nonsmall-cell lung cancer patients. Methods: A total of 125 consecutive patients with clinical single-station N2 non-small-cell lung cancer were treated in our institution between 1992 and 2008. Among them, 97 (78%) patients underwent thoracotomy, and were included in this retrospective study. We defined clinical single-station N2 node as a node measuring 1-2 cm in a single mediastinal station observed on contrast-enhanced computed tomography. The median follow-up period was 5.9 years (range, 1.8-12.6). Results: Eighty-eight (91%) patients underwent lung resection. Of them, 17 (19%) had true (pathologic) single-station N2 disease. Twenty-eight (32%) had pathologic multistation N2 and 43 (49%) had pN0-1 disease with favorable prognoses. The overall survival of the clinical single-station N2/pathologic N2 patients after initial surgery was unsatisfactory with a 5-year overall survival of 23.6%, but their prognoses were heterogeneous. True single-station pathologic N2 status (hazard ratio = 0.35, P = 0.008) and negative subcarinal node status (hazard ratio = 0.34, P = 0.022) were independent favorable prognostic factors after initial resection for clinical single-station N2/ pathologic N2 patients. The patients with both factors revealed a relatively favorable 5-year overall survival of 43.8%. Conclusion: Clinical single-station N2 status does not always correspond with pathologic true N2 status. From a prognostic point of view, initial surgery for clinical single-station N2 patients is indicated if their true single-station N2 status and negative subcarinal involvement are preoperatively confirmed.

AB - Objective: Single-station N2 (Stage IIIA) non-small-cell lung cancer has been reported to have a relatively favorable prognosis after surgery. However, most previous studies examined surgical outcomes in N2 disease by pathologic nodal status but not by clinical nodal status. The objective of this study was to clarify the surgical outcomes in clinical single-station N2 nonsmall-cell lung cancer patients. Methods: A total of 125 consecutive patients with clinical single-station N2 non-small-cell lung cancer were treated in our institution between 1992 and 2008. Among them, 97 (78%) patients underwent thoracotomy, and were included in this retrospective study. We defined clinical single-station N2 node as a node measuring 1-2 cm in a single mediastinal station observed on contrast-enhanced computed tomography. The median follow-up period was 5.9 years (range, 1.8-12.6). Results: Eighty-eight (91%) patients underwent lung resection. Of them, 17 (19%) had true (pathologic) single-station N2 disease. Twenty-eight (32%) had pathologic multistation N2 and 43 (49%) had pN0-1 disease with favorable prognoses. The overall survival of the clinical single-station N2/pathologic N2 patients after initial surgery was unsatisfactory with a 5-year overall survival of 23.6%, but their prognoses were heterogeneous. True single-station pathologic N2 status (hazard ratio = 0.35, P = 0.008) and negative subcarinal node status (hazard ratio = 0.34, P = 0.022) were independent favorable prognostic factors after initial resection for clinical single-station N2/ pathologic N2 patients. The patients with both factors revealed a relatively favorable 5-year overall survival of 43.8%. Conclusion: Clinical single-station N2 status does not always correspond with pathologic true N2 status. From a prognostic point of view, initial surgery for clinical single-station N2 patients is indicated if their true single-station N2 status and negative subcarinal involvement are preoperatively confirmed.

KW - Chemoradiotherapy

KW - Initial surgery

KW - N2

KW - Non-small-cell lung cancer

KW - Single-station

KW - Stage IIIA

UR - http://www.scopus.com/inward/record.url?scp=84892467439&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892467439&partnerID=8YFLogxK

U2 - 10.1093/jjco/hyt164

DO - 10.1093/jjco/hyt164

M3 - Article

VL - 44

SP - 85

EP - 92

JO - Japanese Journal of Clinical Oncology

JF - Japanese Journal of Clinical Oncology

SN - 0368-2811

IS - 1

M1 - hyt164

ER -