Five-year survivors with resected pN2 nonsmall cell lung carcinoma

BACKGROUND. Some patients with resected pN2 lung carcinoma were long term s urvivors. To determine appropriate therapeutic modalities for the selected patients, the clinicopathologic characteristics of these patients were exam ined using the actual number of survivors rather than the cumulative surviv al rate because the cumulative survival rate occasionally is confounded due to patients with short follow-up periods. METHODS. Between 1981-1990, 178 patients with pN2 nonsmall cell lung carcin oma underwent complete resection with systemic lymph node dissection. The r atios of 5-year survivors to all patients in groups with several clinicopat hologic factors were compared. RESULTS. Gender, the side that was operated on, location of the tumor, hist ologic type, or surgical procedure were not related to the ratio of 5-year survivors. However, T classification, skip metastasis, and the number of le vels involved were associated with the ratio significantly. The authors als o found that the location of the involved lymph node(s) affected the ratio. CONCLUSIONS. Even in the presence of pN2 disease, lung carcinoma patients w ith T1 tumors, skip metastasis, or single level mediastinal lymph node invo lvement, especially Level 4, Level 5, or Level 6 lymph nodes, had a relativ ely favorable prognosis and may be candidates for primary resection. (C) 19 99 American Cancer Society.