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J. Räsänen
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P1.08 - Locally Advanced NSCLC (ID 694)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.08-010 - Unsuspected N2 Disease in Patients Undergoing Surgery for Non-Small Cell Lung Cancer: Role of Extent and Location of the Lymph Node Metastasis (ID 8930)
09:30 - 09:30 | Author(s): J. Räsänen
- Abstract
Background:
The role of surgery is controversial in the treatment of non-small cell lung cancer (NSCLC) spread to ipsilateral mediastinal or hilar lymph nodes. In this study we wanted to find out whether the location of lymph nodes positive for NSCLC in the mediastinum or hilum plays a role in the survival of these patients.
Method:
We reviewed retrospectively our 881 patients operated on for NSCLC between 2004 and 2014. Patients having unforeseen spread of cancer to mediastinal (N2) or hilar (station 10) lymph nodes in the final pathology report were further analyzed according to Naruke classification. The mediastinal N2 group was thereafter subdivided into upper (stations 1, 2, 3, 4, 5, 6) and lower mediastinal groups (stations 7, 8, 9). Clinical staging included computed tomography (100%), positron emission tomography (47.6%), and mediastinoscopy (9.8%). Median follow-up after surgery was 54 months.
Result:
Between January 2004 and December 2014 there were 108 pN2 patients and 35 patients with hilar pN1 (station 10 node) involvement. The 5-year overall survival (OS) of the whole group was 19.6%. Better OS was found in patients with nodes positive for upper mediastinal nodes compared to those with lower positive mediastinal nodes or multilevel N2 patients (p=0.027 and p=0.003, respectively). The OS of patients with positive hilar (station 10) nodes did not differ from that of the upper mediastinal positive N2 subgroup. OS of patients with multilevel N2 was significantly worse than the other groups lumped together (p=0.016). Progression free survival (PFS) patients with hilar and upper mediastinal positive nodes had a better outcome compared to multilevel N2 patients (p=0.014 and 0.003, respectively). No significant difference was noted between patients positive for lower positive mediastinal nodes and patients with multilevel N2. Also, PFS multilevel N2 patients had a significantly worse outcome compared to all other groups combined (p=0.004).
Conclusion:
Based on our results, lower positive mediastinal N2 node patients seem to have as unfavorable OS and PFS as multilevel N2 disease patients, and significantly worse prognosis than upper mediastinal node patients. Both OS and PFS of patients with positive hilar disease is similar to the upper mediastinal positive N2 group. We conclude that the location of lymph nodes positive for cancer is a significant factor in the prognosis of NSCLC.
