Clinical Analysis of Sixty-four Patients with T1aN2M0 Stage Non-small Cell Lung Cancer Who Had Undergone Resection

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2016 Apr 5

PMID 27042224

Citations 7

Authors

Jian Xiong

Rui Wang

Yihua Sun

Haiquan Chen

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to evaluate the clinical features of T1aN2M0 stage non-small cell lung cancer (NSCLC).

Method: From November 2008 to May 2013, 498 patients with T1a-stage NSCLC who visited the Shanghai Cancer Center were included in the study. All patients underwent a lobectomy or segmentectomy with systematic nodal resection for primary lung cancer. Analyses of gender, smoking history, primary tumor site, tumor location, tumor size, pathological classification, cancer gene, pleural invasion, number of positive lymph nodes, skip N2, single or multiple station N2, progression-free survival (PFS), and overall survival (OS) were performed.

Result: There were significant differences in tumor size, tumor size distribution, adenocarcinoma subgroup, and number of positive lymph nodes between patients at T1aN2M0 and T1aN0M0 stages. The most common histology of the T1aN2M0 subgroup was adenocarcinoma. Epidermal growth factor receptor mutations were the most common gene mutation in T1aN2M0 stage NSCLC. There were significant differences in five-year OS and PFS rates between patients with T1aN2M0, T1aN0M0, and T1aN1M0 stages. Multivariate analyses of mediastinal lymph node metastasis showed that gender, tumor size distribution, and histology type were significant predictive factors. Multivariate analyses of OS and PFS rates in the T1aN2M0 subgroup showed that the number of positive lymph nodes was a significant predictive factor.

Conclusion: Gender, tumor size distribution, and histology type were independent predictors of mediastinal lymph node metastasis in patients with T1a stage. The number of positive lymph nodes was significantly associated with OS and PFS rates in patients with T1aN2M0 stage NSCLC.

Citing Articles

The Incidence of Node-Positive Non-small-Cell Lung Cancer Undergoing Sublobar Resection and the Role of Radiation in Its Management.

Varlotto J, Emmerick I, Voland R, DeCamp M, Flickinger J, Maddox D Front Oncol. 2020; 10:417.

PMID: 32528866 PMC: 7264374. DOI: 10.3389/fonc.2020.00417.

Survival Following Segmentectomy or Lobectomy in Patients With Stage IB Non-small-cell Lung Cancer.

Hao B, Zhang L, Fan T, Liu B, Jiang W, Hu H Front Oncol. 2020; 10:661.

PMID: 32500023 PMC: 7243118. DOI: 10.3389/fonc.2020.00661.

Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China.

Zhang C, Pang G, Ma C, Wu J, Wang P, Wang K J Immunol Res. 2019; 2019:6263249.

PMID: 31886306 PMC: 6914921. DOI: 10.1155/2019/6263249.

Five-year survival analysis and prognostic factors in patients operated on for non-small cell lung cancer with N2 disease.

Lochowski M, Lochowska B, Rebowski M, Brzezinski D, Cieslik-Wolski B, Kozak J J Thorac Dis. 2018; 10(6):3180-3186.

PMID: 30069313 PMC: 6051815. DOI: 10.21037/jtd.2018.05.173.

Lymph node dissection during sublobar resection: why, when and how?.

Thomas P J Thorac Dis. 2018; 10(Suppl 10):S1145-S1150.

PMID: 29785287 PMC: 5949390. DOI: 10.21037/jtd.2018.01.30.

References

Kudo Y, Saji H, Shimada Y, Matsubayashi J, Nagao T, Kakihana M . Proposal on incorporating blood vessel invasion into the T classification parts as a practical staging system for stage I non-small cell lung cancer. Lung Cancer. 2013; 81(2):187-93. DOI: 10.1016/j.lungcan.2013.04.016. View

Nitadori J, Colovos C, Kadota K, Sima C, Sarkaria I, Rizk N . Visceral pleural invasion does not affect recurrence or overall survival among patients with lung adenocarcinoma ≤ 2 cm: a proposal to reclassify T1 lung adenocarcinoma. Chest. 2013; 144(5):1622-1631. PMC: 3817930. DOI: 10.1378/chest.13-0394. View

Shi C, Zhang X, Han B, He W, Shen J, Chu T . A clinicopathological study of resected non-small cell lung cancers 2 cm or less in diameter: a prognostic assessment. Med Oncol. 2010; 28(4):1441-6. DOI: 10.1007/s12032-010-9632-y. View

Inoue M, Minami M, Shiono H, Sawabata N, Ideguchi K, Okumura M . Clinicopathologic study of resected, peripheral, small-sized, non-small cell lung cancer tumors of 2 cm or less in diameter: pleural invasion and increase of serum carcinoembryonic antigen level as predictors of nodal involvement. J Thorac Cardiovasc Surg. 2006; 131(5):988-93. DOI: 10.1016/j.jtcvs.2005.12.035. View

Lin M, Wu C, Shih J, Chang Y, Yang P . Clinicopathologic characteristics and prognostic significance of EGFR and p53 mutations in surgically resected lung adenocarcinomas ≤2 cm in maximal dimension. J Surg Oncol. 2014; 110(2):99-106. DOI: 10.1002/jso.23628. View

Darling G, Allen M, Decker P, Ballman K, Malthaner R, Inculet R . Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030.... J Thorac Cardiovasc Surg. 2011; 141(3):662-70. PMC: 5082844. DOI: 10.1016/j.jtcvs.2010.11.008. View

Kobayashi N, Toyooka S, Soh J, Ichimura K, Yanai H, Suehisa H . Risk factors for recurrence and unfavorable prognosis in patients with stage I non-small cell lung cancer and a tumor diameter of 20 mm or less. J Thorac Oncol. 2007; 2(9):808-12. DOI: 10.1097/JTO.0b013e31814617c7. View

Ou S, Huang Bartlett C, Mino-Kenudson M, Cui J, Iafrate A . Crizotinib for the treatment of ALK-rearranged non-small cell lung cancer: a success story to usher in the second decade of molecular targeted therapy in oncology. Oncologist. 2012; 17(11):1351-75. PMC: 3500356. DOI: 10.1634/theoncologist.2012-0311. View

Jeon H, Kim Y, Kim K, Sung S, Park H, Park J . Sublobar resection versus lobectomy in solid-type, clinical stage IA, non-small cell lung cancer. World J Surg Oncol. 2014; 12:215. PMC: 4115487. DOI: 10.1186/1477-7819-12-215. View

10.

Jeon J, Kang C, Kim H, Seong Y, Park I, Kim Y . Prognostic and predictive role of epidermal growth factor receptor mutation in recurrent pulmonary adenocarcinoma after curative resection. Eur J Cardiothorac Surg. 2014; 47(3):556-62. DOI: 10.1093/ejcts/ezu177. View

11.

Li H, Hu H, Wang R, Pan Y, Wang L, Li Y . Primary concomitant EGFR T790M mutation predicted worse prognosis in non-small cell lung cancer patients. Onco Targets Ther. 2014; 7:513-24. PMC: 3979794. DOI: 10.2147/OTT.S60122. View

12.

Fang S, Wang Z . EGFR mutations as a prognostic and predictive marker in non-small-cell lung cancer. Drug Des Devel Ther. 2014; 8:1595-611. PMC: 4189714. DOI: 10.2147/DDDT.S69690. View

13.

Jonnalagadda S, Smith C, Mhango G, Wisnivesky J . The number of lymph node metastases as a prognostic factor in patients with N1 non-small cell lung cancer. Chest. 2011; 140(2):433-440. PMC: 3148795. DOI: 10.1378/chest.10-2885. View

14.

Mohiuddin K, Haneuse S, Sofer T, Gill R, Jaklitsch M, Colson Y . Relationship between margin distance and local recurrence among patients undergoing wedge resection for small (≤2 cm) non-small cell lung cancer. J Thorac Cardiovasc Surg. 2014; 147(4):1169-75. DOI: 10.1016/j.jtcvs.2013.11.056. View

15.

Liu T, Liu H, Li Y . Systematic lymph node dissection is necessary for T1a non-small cell lung cancer. Asia Pac J Clin Oncol. 2014; 11(1):49-53. DOI: 10.1111/ajco.12194. View

16.

Su X, Wang X, Long H, Fu J, Lin P, Zhang L . Mediastinal lymph node dissection affects survival in patients with stage I non-small cell lung cancer. Thorac Cardiovasc Surg. 2008; 56(4):226-30. DOI: 10.1055/s-2007-989494. View

17.

Yamato Y, Koike T, Yoshiya K, Shinohara H, Toyabe S . Results of surgical treatment for small (2 cm or under) adenocarcinomas of the lung. Surg Today. 2008; 38(2):109-14. DOI: 10.1007/s00595-007-3594-5. View

18.

Villamizar N, Swanson S . Lobectomy vs. segmentectomy for NSCLC (T<2 cm). Ann Cardiothorac Surg. 2014; 3(2):160-6. PMC: 3988300. DOI: 10.3978/j.issn.2225-319X.2014.02.11. View

19.

Xu F, Qi L, Yue D, Wang C . The effect of the extent of lymph node dissection for stage IA non-small-cell lung cancer on patient disease-free survival. Clin Lung Cancer. 2012; 14(2):181-7. DOI: 10.1016/j.cllc.2012.09.002. View

20.

Watanabe S, Oda M, Go T, Tsunezuka Y, Ohta Y, Watanabe Y . Should mediastinal nodal dissection be routinely undertaken in patients with peripheral small-sized (2 cm or less) lung cancer? Retrospective analysis of 225 patients. Eur J Cardiothorac Surg. 2001; 20(5):1007-11. DOI: 10.1016/s1010-7940(01)00954-x. View