Type of lymph node involvement and survival in pathologic N1 stage III non-small cell lung carcinoma

Background. Survival of patients with stage II nonsmall lung cancer by the 1986 classification depends on the type of lymph node involvement (by direc t extension or by metastases in lobar or hilar lymph nodes). The influence of these types of lymph node involvement on survival was investigated in pa thologic N1 stage III patients. Methods. Of 2,009 patients having operation from 1977 through 1993, the cas es of 123 patients with pathologic N1 stage III disease (80 T3 N1 and 43 T4 N1) were reviewed. The N1 status was refined by the specific type of lymph node involvement. Results. The cumulative 5-year survival rate of all hospital survivors (n = 111) was 27.2%. A significant difference in mean 5-year survival rate was observed between patients who underwent complete resection and those with i ncomplete resection (34.4% versus 11.4%; p = 0.0001). Further analysis was performed with hospital survivors having complete resection only (n = 76). The cumulative 5-year survival rate was 34.4%. Type of lymph node involveme nt did not relate to survival for the group as a whole or for the T3 and T4 subsets. Survival was not related to age, histology, type of resection, or tumor size. Conclusions. Moderately good results can be obtained with surgical resectio n for stage III patients with pathologic N1 disease. In contrast with stage II, complete resection of pathologic N1 higher-stage non-small cell lung c arcinoma is not influenced by type of lymph node involvement. (Ann Thorac S urg 1999;67:903-7) (C) 1999 by The Society of Thoracic Surgeons.