Original articleGeneral thoracicThe Significance of One-Station N2 Disease in the Prognosis of Patients With Nonsmall-Cell Lung Cancer
Section snippets
Material and Methods
From January 1993 to December 2004, 1,329 patients underwent lung resection for bronchogenic carcinoma pathologically staged as pI–IIIA. The Scientific and Ethics Committee of Sismanogleio General Hospital has approved the conduction of the study. Individual consent for the study was waived.
This group included 1,077 men (81%) and 252 women (19%), aged 44 tp 78 years (median, 62). The types of resection included 372 pneumonectomies (27.9%), 219 right (59%) and 153 left (41%), and 957 lobectomies
Results
Patients at stage pIIIA/N2 were the target group to be studied. This group consisted of 302 patients (22.7%). The demographic and clinicopathologic characteristics of this group are fully described in Table 1.
The incidence of mediastinal lymph node involvement according to primary tumor location was studied (Table 2). In 59% of the cases, the upper mediastinal lymph nodes were invaded, 22.5% of the lower ones and 18.5% of both the upper and lower lymph node stations. Positive lymph nodes
Comment
One should not take for granted that cancer lymphatic spread follows a linear model from intraparenchymal nodes to hilar, mediastinal, and extrathoracic ones. The lymphatic network draining the lung is extensive and variability is probably the rule. Riquet and colleagues [11] have reported direct lymph passages from each lobe to the mediastinum. More commonly, these communications were observed in the upper lobes. This provides multiple pathways for dissemination, creating a complicated model
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