ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2016
Microscopic N2 disease exhibits a better prognosis in resected non-small-cell lung cancer.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Endosonography With or Without Confirmatory Mediastinoscopy for Resectable Lung Cancer: A Randomized Clinical Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Comparative analysis of methodologies for predicting overall survival in patients with non-small cell lung cancer based on the number and rate of resected positive lymph nodes: A study based on the SEER database for 2010 through 2019.The clinical respiratory journal · 2023Article
- True Prevalence of Unforeseen N2 Disease in NSCLC: A Systematic Review + Meta-Analysis.Cancers · 2023Review
- Analysis of prognostic factors in pT1-2 N1 lung cancer patients in the light surgical results.Updates in surgery · 2023Article
- Rate and Predictors of Unforeseen PN1/PN2-Disease in Surgically Treated cN0 NSCLC-Patients with Primary Tumor > 3 cm: Nationwide Results from Italian VATS-Group Database.Journal of clinical medicine · 2023Article
- Neoadjuvant treatment of stage IIIA-N2 inTranslational lung cancer research · 2021Review
- Alternative methods of lymph node staging in lung cancer: a narrative review.Journal of thoracic disease · 2020Review
- Prognostic Value of Tumor Size in Resected Stage IIIA-N2 Non-Small-Cell Lung Cancer.Journal of clinical medicine · 2020Article
- Editorial on "upfront surgery as first-line therapy in selected patients with stage IIIA non-small cell lung cancer".Journal of thoracic disease · 2018Article
- Unless I see, I will not believe.Journal of thoracic disease · 2017Article
- Occult pN2 disease in lung cancer patients: a wide range of diseases endangering the long term prognosis.Journal of thoracic disease · 2017Article
- Surgery in microscopically pathological N2 non-small cell lung cancer: the size of lymph node matters.Journal of thoracic disease · 2017Article
- Clinical value of nodal micrometastases in patients with non-small cell lung cancer: time for reconsideration?Journal of thoracic disease · 2016Article
- N2-IIIA non-small cell lung cancer: a plea for surgery!Journal of thoracic disease · 2016Review
- Specific KRAS amino acid substitutions and EGFR mutations predict site-specific recurrence and metastasis following non-small-cell lung cancer surgery.British journal of cancer · 2016Article
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7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe management of pIIIA-N2 non-small-cell lung cancer (NSCLC) is still controversial. In particular, there are wide variations in overall survival (OS), suggesting the existence of subgroups among N2 patients. We aimed to evaluate the prognostic value of microscopic pN2 in NSCLC.
methodsBetween 1996 and 2015, the data from all 982 pathologically stage IIIA-N2 patients who underwent surgery with curative intent for NSCLC were retrospectively reviewed. Microscopic pN2 disease was defined as a nodal metastasis ranging from 0.2 to 2 mm in size.
resultsWith a median follow-up of 17 months (2-101), the 5-year OS for the whole cohort was 31%. Microscopic N2 was observed in 309 (31.5%) patients. Microscopic N2 was associated with better median OS compared with macroscopic N2 [42 months (95% CI 36.85-47.15) vs 23 months (95% CI 19.7-26.29), P < 0.0001, with a corresponding 5-year OS rate of 39 and 21%, respectively]. In multivariate analysis, microscopic N2 remained a favourable independent prognostic factor [HR 0.681 (95% CI 0.481-0.967), P = 0.03]. The median OS of microscopic N2 patients who benefitted from simple follow-up was significantly better than those who underwent chemotherapy, radiation therapy or both [43 months (95% CI 24.22-61.78) vs 22 months (95% CI 17.43-26.47) vs 31 months (95% CI 27.66-34.34) vs 16 months (95% CI 14.6-17.4), P = 0.008].
conclusionMicroscopic N2 seems to be associated with better prognosis in patients with pIIIA-N2 NSCLC and these could benefit from a simple follow-up. Prospective cohort studies are necessary to confirm these preliminary results.
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