T2N1M0 Non-Small Cell Lung Cancer: Surgery and Prognostic Factors

Padilla, J.; Calvo, V.; Peñalver, J.C.; Jordá, C.; Escrivá, J.; Cerón, J.; Zarza, A. García; Pastor, J.; Blasco, E.

doi:10.1016/S1579-2129(06)60258-9

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 41. Issue 8.

Pages 430-433 (August 2005)

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Pages 430-433 (August 2005)

Original Articles

DOI: 10.1016/S1579-2129(06)60258-9

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T2N1M0 Non-Small Cell Lung Cancer: Surgery and Prognostic Factors

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J. Padilla

Corresponding author

jpadilla@comv.es

Correspondence: Dr. J. Padilla. Servicio de Cirugía Torácica. Hospital Universitario La Fe. Avda. de Campanar, 21. 46009 Valencia. España

, V. Calvo, J.C. Peñalver, C. Jordá, J. Escrivá, J. Cerón, A. García Zarza, J. Pastor, E. Blasco

Servicio de Cirugía Torácica, Hospital Universitario La Fe, Valencia, Spain

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Objective

TO determine the prognostic factors for the survival in a group of patients operated on for a non-small cell lung cancer classified as T2N1M0.

Patients and methods

TWO hundred sixteen patients treated exclusively with surgery were studied. Kaplan-Meier survival and Cox multivariable regression analyses were used.

Results

The overall survival rate was 39.8% at 5 years and 29.9% at 10 years. Sex, age, presence or absence of symptoms, type of resection, and number and location of affected lymph nodes had no effect on survival. Tumor size (P = .04) and histologic type (P = .03) did significantly affect prognosis. Both variables entered into the Cox multivariable regression model.

Conclusions

Patients operated on for non-small cell lung cancer classified as T2N1M0 have an overall probability of 5-year survival of approximately 40%. However, the prognosis for this group of patients is heterogeneous: in our study it was affected by the histologic type (45.5% for squamous cell and 25% for non-squamous cell cancers) and tumor size (53% for tumors with a diameter of ≤3 cm, 45% for tumors between 3.1 and 5 cm, and 29% for a tumor diameter >5 cm).

Key Words:

Carcinoma bronchogenic

Stage IIb

T2N1M0

Surgery

Prognosis

Objetivo

Determinar los factores pronósticos de supervi-vencia de un grupo de pacientes operados de un carcinoma broncogénico no anaplásico de células pequeñas y clasifica-dos como T2N1M0.

Pacientes y métodos

Se estudió a 216 pacientes tratados exclusivamente con cirugía. La supervivencia se analizó con el método de Kaplan-Meier y se utilizó el modelo de Cox para el análisis multivariante.

Resultados

La supervivencia global fue del 39,8% a los 5 años y del 29,9% a los 10 años. El sexo, la edad, la presen-cia o ausencia de síntomas, la amplitud de la exéresis, el nú-mero de ganglios afectados y su localización no influyeron en la supervivencia. El tamaño tumoral (p = 0,04) y la estir-pe histológica (p = 0,03) sí condicionaron significativamente el pronóstico. Ambas variables entraron en regresión cuan-do se utilizó el análisis multivariante.

Conclusiones

Los pacientes operados de un carcinoma broncogénico no anaplásico de células pequeñas clasificado como T2N1M0 tienen una probabilidad de supervivencia global a los 5 años en torno al 40%. Sin embargo, no es un grupo de pacientes con un pronóstico homogéneo, ya que en nuestro estudio estuvo condicionado por la estirpe histológica (un 45,5% para los epidermoides y un 25% para los no epidermoides) y el tamaño tumoral (un 53% en los tumores con un diámetro ≤ 3 cm, un 45% entre 3,1-5 cm y un 29% en > 5 cm).

Palabras clave:

Carcinoma broncogénico

Estadio IIb

T2N1M0

Cirugía

Factores pronósticos

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REFERENCES

[1]

Grupo de Trabajo de la SEPAR.

Normativa actualizada (1998) sobre diagnóstico y estadificación del carcinoma broncogénico.

Arch Bronconeumol, 34 (1998), pp. 437-452

Medline

[2]

N Martini, M Burt, M Bains, P McCormack, V Rusch, R Ginsberg.

Survival after resection of stage II non-small cell lung cancer.

Ann Thorac Surg, 54 (1992), pp. 460-466

Medline

[3]

CF Mountain.

Revision in the international staging system for lung cancer.

Chest, 111 (1997), pp. 1710-1717

Medline

[4]

K Inoue, M Sato, S Fujimura, A Sakurada, S Takahashi, K Usuda, et al.

Prognostic assessment of 1310 patients with non-small-cell lung cancer who underwent complete resection from 1980 to 1993.

J Thorac Cardiovasc Surg, 116 (1998), pp. 407-411

http://dx.doi.org/10.1016/S0022-5223(98)70006-6 | Medline

[5]

T Naruke, R Tsuchiya, H Kondo, H Asamura.

Prognosis and survival after resection for bronchogenic carcinoma based on the 1997 TNM-staging classification: the Japanese experience.

Ann Thorac Surg, 71 (2001), pp. 1759-1764

Medline

[6]

V Calvo Medina, J Padilla Alarcón, F París Romeu, E Blasco Armengod, J Pastor Guillem, A García Zarza.

Supervivencia posquirúrgica en el estadio II del carcinoma broncogénico no anaplásico de células pequeñas.

Arch Bronconeumol, 37 (2001), pp. 19-26

Medline

[7]

E van Velzen, RJ Snijder, A Brutel de la Rivière, HJ Elbers, JM van den Bosch.

Lymph node type as a prognostic factor for survival in T2N1M0 non-small cell lung carcinoma.

Ann Thorac Surg, 63 (1997), pp. 1436-1440

Medline

[8]

T Naruke, K Suemasu, S Ishikawa.

Lymph node mapping and curability at various levels of metastasis in resected lung cancer.

J Thorac Cardiovasc Surg, 76 (1978), pp. 832-839

Medline

[9]

T Yano, H Yokoyama, T Inoue, H Asoh, K Tayama, Y Ichinose.

Surgical results and prognostic factors of pathologic N1 disease in non-small-cell carcinoma.

J Thorac Cardiovasc Surg, 107 (1994), pp. 1398-1402

Medline

[10]

M Riquet, D Manac'h, F le Pimpec-Barthes, A Dujon, A Chehab.

Prognostic significance of surgical-pathologic N1 disease in non-small cell carcinoma of the lung.

Ann Thorac Surg, 67 (1999), pp. 1572-1576

Medline

[11]

A Marra, L Hillejan, G Zaboura, T Fujimoto, D Greschuchna, G Stamatis.

Pathologic N1 non-small cell lung cancer: correlation between pattern of lymphatic spread and prognosis.

J Thorac Cardiovasc Surg, 125 (2003), pp. 543-553

http://dx.doi.org/10.1067/mtc.2003.322 | Medline

[12]

T Osaki, A Nagashima, T Yoshimatsu, Y Tashima, K Yasumoto.

Survival and characteristics of lymph node involvement in patients with N1 non-small cell lung cancer.

Lung Cancer, 43 (2004), pp. 151-157

Medline

[13]

Sayar A, Turna A, Kilicgun A, Solak O, Urer N, Gurses A. Prognostic significance of surgical-pathologic multiple-station N1 disease in non-small cell carcinoma of the lung. Eur J Cardiothorac Surg. 200;25:434-8.

[14]

S Watanabe, G Ladas, P Goldstraw.

Inter-observer variability in systematic nodal dissection: a comparison of European and Japanese nodal designation.

Ann Thorac Surg, 73 (2002), pp. 245-248

Medline

[15]

H Asamura, K Suzuki, H Kondo, R Tsuchiya.

Where is the boundary between N1 and N2 stations in lung cancer?.

Ann Thorac Surg, 70 (2000), pp. 1839-1842

Medline

[16]

PORT Meta-analysis Trialists Group.

Postoperative radiotherapy in non-small-cell lung cancer: systematic review and meta-analysis of individual patient data from nine randomised controlled trials.

Lancet, 352 (1998), pp. 257-263

Medline

[17]

Non-small Cell Lung Cancer Collaborative Group.

Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials.

BMJ, 311 (1995), pp. 899-909

Medline

[18]

The International Adjuvant Lung Cancer Trial Collaborative Group.

Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer.

N Engl J Med, 350 (2004), pp. 351-360

http://dx.doi.org/10.1056/NEJMoa031644 | Medline

[19]

KMW Pister, RJ Ginsberg, DJ Giroux, JB Putnam, MG Kriss, DH Johnson, et al.

Induction chemotherapy before surgery for early-stage lung cancer: a novel approach.

J Thorac Cardiovasc Surg, 119 (2000), pp. 423-439

[20]

A Depierre, B Milleron, D Moro-Sibilot, S Chevret, E Quoix, B Lebeau, et al.

Preoperative chemotherapy followed by surgery compared with primary surgery in resectable stage I (except T1N0) II, and IIIa non-small cell lung cancer.

J Clin Oncol, 20 (2002), pp. 247-253

http://dx.doi.org/10.1200/jco.2002.20.1.247 | Medline