Mediastinal lymph node involvement(M2 disease) is generally accepted as an important factor influencing the outcome of patients with lung cancer.
The 5-year survival rates of completely resected patients with N2 disease are frequently reported from 15% to 30%.
To improve the management and the outcome of patients with resectable N2 disease, we analyzed the survival rates and the prognostic factors for resected N2 lung cancer.
Between August 1989 and September 1993, we experienced 27 patients with N2 disease of 115 surgically treated lung cancer at the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan.
Of these 27 N2 disease 23 had the pulmonary resections; 15 have been undertaken pneumonectomy, 3 bilobectomy, 4 lobectomy and 1 sleeve lobectomy, and 4 had the exploratory thoracotomies.
All of these 23 patients received postoperative adjuvant therapy; 18 received combined chemo-radiotherapy, 3 chemotherapy and 2 radiotherapy.
Complete follow-up was obtained in 23 patients and median survival was 22 months and overall 1-year and 2-year survival rates by Kaplan-Meir method were 65% and 45%, respectively.
However, survival rates according to histology, tumor location, number of positive nodal station and operative method were not significantly different by statistical analysis.
As a conclusion, it is considered that in resectable N2 lung cancer, complete mediastinal lymph node dissection as well as tumor resection combined with postoperative adjuvant therapy will contribute to the improvement of long-term survival.
(Korean J
Thoracic Cardiovas Surg 1993;26:934-9)
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