Skip to main content

Advertisement

SpringerLink
Log in

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

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. Introduction to THE 2015 World Health Organization classification of tumors of the lung, pleura, thymus, and heart. J Thorac Oncol. 2015;10(9):1240–2.

    Article  PubMed  Google Scholar 

  2. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10(9):1243–60.

    Article  PubMed  Google Scholar 

  3. Alberg AJ, Ford JG, Samet JM. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edn). Chest. 2007;132(3 Suppl):29S–55S.

  4. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65(1):5–29.

    Article  PubMed  Google Scholar 

  5. Travis WD, Brambilla E, Riely GJ. New pathologic classification of lung cancer: relevance for clinical practice and clinical trials. J Clin Oncol. 2013;31(8):992–1001.

    Article  CAS  PubMed  Google Scholar 

  6. Goldstraw P. New staging system: how does it affect our practice? J Clin Oncol. 2013;31(8):984–91.

    Article  CAS  PubMed  Google Scholar 

  7. Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol. 2007;2(8):706–14.

    Article  PubMed  Google Scholar 

  8. Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest. 1997;111(6):1718–23.

    Article  CAS  PubMed  Google Scholar 

  9. Clement-Duchene C, Vignaud JM, Stoufflet A, et al. Characteristics of never smoker lung cancer including environmental and occupational risk factors. Lung Cancer. 2010;67(2):144–50.

    Article  PubMed  Google Scholar 

  10. Alexiou C, Onyeaka CV, Beggs D, et al. Do women live longer following lung resection for carcinoma? Eur J Cardiothorac Surg. 2002;21(2):319–25.

    Article  PubMed  Google Scholar 

  11. Batevik R, Grong K, Segadal L, Stangeland L. The female gender has a positive effect on survival independent of background life expectancy following surgical resection of primary non-small cell lung cancer: a study of absolute and relative survival over 15 years. Lung Cancer. 2005;47(2):173–81.

    Article  PubMed  Google Scholar 

  12. de Perrot M, Licker M, Bouchardy C, Usel M, Robert J, Spiliopoulos A. Sex differences in presentation, management, and prognosis of patients with non-small cell lung carcinoma. J Thorac Cardiovasc Surg. 2000;119(1):21–6.

    Article  PubMed  Google Scholar 

  13. Ferguson MK, Skosey C, Hoffman PC, Golomb HM. Sex-associated differences in presentation and survival in patients with lung cancer. J Clin Oncol. 1990;8(8):1402–7.

    Article  CAS  PubMed  Google Scholar 

  14. Fu JB, Kau TY, Severson RK, Kalemkerian GP. Lung cancer in women: analysis of the National Surveillance, Epidemiology, and End Results Database. Chest. 2005;127(3):768–77.

    Article  PubMed  Google Scholar 

  15. Hanagiri T, Sugio K, Uramoto H, et al. Gender difference as a prognostic factor in patients undergoing resection of non-small cell lung cancer. Surg Today. 2007;37(7):546–51.

    Article  PubMed  Google Scholar 

  16. Ouellette D, Desbiens G, Emond C, Beauchamp G. Lung cancer in women compared with men: stage, treatment, and survival. Ann Thorac Surg. 1998;66(4):1140–3; discussion 1143–4.

    Article  CAS  PubMed  Google Scholar 

  17. Visbal AL, Williams BA, Nichols FC, 3rd, et al. Gender differences in non-small-cell lung cancer survival: an analysis of 4,618 patients diagnosed between 1997 and 2002. Ann Thorac Surg. 2004;78(1):209–15; discussion 215.

    Article  PubMed  Google Scholar 

  18. Wakelee HA, Wang W, Schiller JH, et al. Survival differences by sex for patients with advanced non-small cell lung cancer on Eastern Cooperative Oncology Group trial 1594. J Thorac Oncol. 2006;1(5):441–6.

    Article  PubMed  Google Scholar 

  19. Caldarella A, Crocetti E, Comin CE, Janni A, Pegna AL, Paci E. Gender differences in non-small cell lung cancer: a population-based study. Eur J Surg Oncol. 2007;33(6):763–8.

    Article  CAS  PubMed  Google Scholar 

  20. Foegle J, Hedelin G, Lebitasy MP, Purohit A, Velten M, Quoix E. Specific features of non-small cell lung cancer in women: a retrospective study of 1738 cases diagnosed in Bas-Rhin between 1982 and 1997. J Thorac Oncol. 2007;2(6):466–74.

    Article  PubMed  Google Scholar 

  21. Zhang J, Gold KA, Lin HY, et al. Relationship between tumor size and survival in non-small-cell lung cancer (NSCLC): an analysis of the surveillance, epidemiology, and end results (SEER) registry. J Thorac Oncol. 2015;10(4):682–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Legras A, Mordant P, Arame A, et al. Long-term survival of patients with pN2 lung cancer according to the pattern of lymphatic spread. Ann Thorac Surg. 2014;97(4):1156–62.

    Article  PubMed  Google Scholar 

  23. Yoo C, Yoon S, Lee DH, et al. Prognostic significance of the number of metastatic pN2 lymph nodes in stage IIIA-N2 non-small-cell lung cancer after curative resection. Clin Lung Cancer. 2015;16(6):e203–12.

    Article  PubMed  Google Scholar 

  24. Kang CH, Ra YJ, Kim YT, Jheon SH, Sung SW, Kim JH. The impact of multiple metastatic nodal stations on survival in patients with resectable N1 and N2 nonsmall-cell lung cancer. Ann Thorac Surg. 2008;86(4):1092–7.

    Article  PubMed  Google Scholar 

  25. Sakuraba M, Takahashi N, Oh S, Miyasaka Y, Inagaki T, Suzuki K. Long-term survival after complete mediastinal lymph node resection and lobectomy in patients with bulky N2 non-small cell lung cancer. Ann Thorac Cardiovasc Surg. 2011;17(2):124–9.

    Article  PubMed  Google Scholar 

  26. Baba T, Uramoto H, Kuwata T, et al. Survival impact of node zone classification in resected pathological N2 non-small cell lung cancer. Interact Cardiovasc Thorac Surg. 2012;14(6):760–4.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Fernandes AT, Mitra N, Xanthopoulos E, et al. The impact of extent and location of mediastinal lymph node involvement on survival in stage III non-small cell lung cancer patients treated with definitive radiotherapy. Int J Radiat Oncol Biol Phys. 2012;83(1):340–7.

    Article  PubMed  Google Scholar 

  28. Guo D, Ni Y, Lv X, Zhang Z, Ye P. Distribution and prognosis of mediastinal lymph node metastases of nonsmall cell lung cancer. J Cancer Res Ther. 2016;12(Supplement):120–5.

    PubMed  Google Scholar 

Download references

Disclosure

No conflict of interest, and no commercial interest.

Author information

Authors and Affiliations

  1. Oncology Department, Institut de Cancérologie de Lorraine, Nancy, France

    Christelle Clément-Duchêne MD, PhD

  2. Centre de Recherche en Automatique de Nancy (CRAN), Nancy, France

    Christelle Clément-Duchêne MD, PhD

  3. Unité de Méthodologie, Data-management et Statistique, University Hospital, Nancy, France

    Amandine Luc MS

  4. Pathology Department, University Hospital, Nancy, France

    Jean-Matthieu Casse MD, Jean-Michel Vignaud MD, PhD & Stéphanie Lacomme MS

  5. Surgery Department, HP Metz, Metz, France

    Valentine Anne MD

  6. Surgery Department, University Hospital, Nancy, France

    Joëlle Siat MD

  7. Chest Department, University Hospital, Nancy, France

    Olivier Ménard MD & Yves Martinet MD, PhD

Authors
  1. Christelle Clément-Duchêne MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amandine Luc MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean-Matthieu Casse MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Michel Vignaud MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stéphanie Lacomme MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Valentine Anne MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Joëlle Siat MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Olivier Ménard MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yves Martinet MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christelle Clément-Duchêne MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Clément-Duchêne, C., Luc, A., Casse, JM. et al. Survival Impact of Stations of Pathological Lymph Nodes in N2 Non-small Cell Lung Cancer in a French Hospital. Ann Surg Oncol 25, 1262–1268 (2018). https://doi.org/10.1245/s10434-018-6373-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-018-6373-1

Keywords

Search

Navigation