ArticleJournal of thoracic disease2018
Upfront surgery in patients with clinical skip N2 lung cancer based on results of modern radiological examinations.
Article in Journal of thoracic disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Topohistology of dendritic cells and macrophages in the distal and proximal nodes along the lymph flow from the lung.Journal of anatomy · 2025Article
- Upfront surgery for stage IIIA/B non-small cell lung cancer: retrospective cohort study.BJS open · 2024Article
- Prognostic significance of mediastinal standardized uptake value on positron emission tomography/computed tomography in patients with left upper lobe non-small cell lung cancer: Is invasive staging of aortopulmonary window lymph nodes necessary?Turk gogus kalp damar cerrahisi dergisi · 2023Article
- Extracapsular extension of pN2 lymph node metastases is not prognostically significant in surgically resected patients with non-small cell lung cancer.Innovative surgical sciences · 2023Article
- The role of EBUS-TBNA in lung cancer restaging and mutation analysis.Mediastinum (Hong Kong, China) · 2020Review
- New perspective to evaluate N1 staging: The peripheral lymph node metastasis status of non-small cell lung cancer.Thoracic cancer · 2019Article
- The current only location-based nodal classification in NSCLC may be inadequate.Journal of thoracic disease · 2019Article
- Is there a role for upfront surgery in patients with N2 disease and good prognostic features?Journal of thoracic disease · 2019Article
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Abstract
backgroundDirect lymphatic drainage from a primary tumor to the right paratracheal or aortic window lymph nodes is often noted in pN2 disease. This multi-institutional retrospective study investigated the outcomes of upfront surgery in patients with clinical skip N2 disease (N2 disease without N1 disease) and a tumor in the right upper lobe or left upper segment based on results of modern radiological examinations, including positron emission tomography (PET).
methodsWe identified 143 patients with cN2 disease who underwent upfront surgery in 12 institutions under the Thoracic Surgery Study Group of Osaka University between January 2006 and December 2013. Among 143 patients, 94 who underwent PET were analyzed. We classified these patients into Group A (n=39; clinical skip N2 disease and a tumor in the right upper lobe or left upper segment) and Group B (n=55; other).
resultsThe median follow-up was 56.5 months. Among the 94 patients, 50 (53.2%) had skip N2 disease and 65 (69.1%) had a tumor in the right upper lobe or left upper segment. The 5-year overall survival (OS) rates of the 94 patients with cN2 disease was 47.9%. The 5-year OS rates for the cN2pN0/1 (n=22) and cN2pN2 (n=70) groups were 74.9% and 41.2%, respectively (P=0.034). The univariate analysis of OS revealed no significant differences in age, sex, histology, carcinoembryonic antigen (CEA) level, tumor size, PET findings, and number of metastatic lymph nodes when these parameters were dichotomized. A significantly better 5-year OS rate was observed in Group A than in Group B (64.0%
conclusionsPatients with cN2 disease in Group A had a more favorable prognosis. Upfront surgery may be a treatment option for such selected patients with non-small lung cancer in the specific group.
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