Virtual Library
Start Your Search
M. Yoshimura
Author of
-
+
P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P1.05-040 - Prognostic Factor of Node Involvement Pattern in Completely Resected pN1 Squamous Cell Carcinoma Patients (ID 3971)
14:30 - 14:30 | Author(s): M. Yoshimura
- Abstract
Background:
In patients with non-small cell lung cancer, the degree of regional lymph node involvement is an important prognostic factor. The prognostic significance of lymph node involvement pattern is unclear in the seventh edition of TNM classification. Squamous cell carcinoma (SCC) often arises in the central way and directly invades intrapulmonary and hilar lymph nodes. In this study, we reviewed our population of operated SCC patients classified as pathologically N1 (pN1) to evaluate the association between N1 lymph node involvement patterns and the prognosis.
Methods:
From our institutional database of 3,264 consecutive patients underwent surgical resection for NSCLC at our hospital between January 1987 and December 2010, we examined 152 patients with completely resected pN1 squamous cell carcinoma. We performed reassessment of the data according to the seventh edition of TNM classification of lung cancer. We divided the patients into two groups based on lymph node involvement pattern; direct and separate pattern. The direct pattern was defined as lymph node metastasis by the primary tumor directly with continuity, separate pattern as metastasis without continuity. Survival curves were generated by the Kaplan-Meier method and multivariate analysis was based on the Cox proportional hazards model.
Results:
In the lymph nodes metastasis pattern, 75 (49%) patients were the direct group, 77 (51%) patients were the separate group. The percentage of sleeve lobectomy was significantly higher in the direct group and lobectomy without bronchoplastic procedure was higher in the separate group. The median follow-up period was 50 months. The 5-year survivals of the direct and separate group were 54% and 41% (p = 0.01). The 5-year survival of patients with the direct group was as good as pN0 patients (p = 0.78). No survival difference between the separate group and pN2 patients was noted (p = 0.06). Overall recurrence rate of the direct group (44% [33/75]) was lower than the separate group (50% [39/77]), but there was no significant difference among them (p = 0.09). No significant difference was noted in recurrence pattern (distant or locoregional) when comparing the direct group or separate group (p = 0.27). By multivariate analyses of survival, lymph node involvement pattern (p = 0.02) and lymphatic infiltration (p = 0.02) was independent prognostic factor.
Conclusion:
Lymph node involvement pattern of patients with pN1 squamous cell carcinoma is significant prognostic factor. Survival of the direct pattern is higher than the separate pattern.
