Prognostic significance of metastases to mediastinal lymph node levels in resected non-small cell lung carcinoma.

Abstract

The prognosis of patients who have non-small cell lung carcinoma (NSCLC) with mediastinal lymph node metastases remains a controversial issue. This study was performed to evaluate survival by level of mediastinal lymph node metastasis and the number of mediastinal levels involved. The authors retrospectively reviewed the cases of 113 patients with NSCLC and pathologic mediastinal lymph node involvement who underwent a complete tumor resection and ipsilateral mediastinal lymphadenectomy. Most patients presented with involvement of only one mediastinal lymph node level (68.2%). The overall survival rate was 17% at 3 years. No differences in survival were observed in relation to which lymph node level was involved (P = 0.667). Differences in survival based on the number of lymph node levels involved were statistically significant (P = 0.001). Although there were no differences in survival when only one of any of the three defined levels was involved, metastasis to more than one level was associated with significantly poorer survival.