Preoperative prognostic factors for pN2 non-small cell lung cancer.

PURPOSE: The prognosis of non-small cell lung cancer (NSCLC) with pathologic mediastinal lymph node involvement (pN2) is poor in general. The majority of previously reported prognostic factors of pN2 disease are not available preoperatively. When we perform preoperative induction chemotherapy, we should undertake therapeutic planning according to preoperative factors.

METHODS

We focused on preoperative clinicopathologic factors, and investigated the prognosis in 78 patients with pN2 NSCLC who received complete resection.

RESULTS

Age, gender, histologic subtype, tumor location, smoking status and cT status were not related to patients' survival. On the other hand patients with cN0 disease and normal serum carcinoembryonic antigen (CEA) level had a significant favorable survival (p = 0.038 and p = 0.019, respectively). In addition, comorbidity had a significant survival impact (p = 0.031). Despite there being no independent prognostic factors by multivariate analysis, the patients without all of cN1-2 disease, elevated serum CEA level and comorbidity had a significant favorable prognosis (p = 0.008).

CONCLUSION

Among the preoperative factors examined, pN2 patients with all cN0 disease, normal serum CEA level and no comorbidities might have a favorable prognosis. Combined use of these might be a useful prognostic determinant, and even in the presence of pN2 disease, patients without these unfavorable 3 factors might have a favorable prognosis when treated with surgery alone.