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Validity of International Association for the Study Of Lung Cancer proposals for the revision of N descriptors in lung cancer.

 Jin Gu Lee  ;  Chang Young Lee  ;  Mi Kyung Bae  ;  In Kyu Park  ;  Dae Joon Kim  ;  Kil Dong Kim  ;  Kyung Young Chung 
 JOURNAL OF THORACIC ONCOLOGY, Vol.3(12) : 1421-1426, 2008 
Journal Title
Issue Date
Adenocarcinoma/classification ; Adenocarcinoma/secondary ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Large Cell/classification ; Carcinoma, Large Cell/secondary ; Carcinoma, Non-Small-Cell Lung/classification* ; Carcinoma, Non-Small-Cell Lung/secondary ; Carcinoma, Squamous Cell/classification ; Carcinoma, Squamous Cell/secondary ; Female ; Humans ; International Cooperation* ; Lung Neoplasms/classification* ; Lung Neoplasms/pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate
Lung cancer ; Lymph nodes ; Zone ; Outcome
OBJECTIVE: This study was conducted to assess the validity of the pending suggestions for N descriptors by the International Association for the Study of Lung Cancer. METHODS: Medical records from 1032 patients with non-small cell lung cancer who had pulmonary resection and proven stage I-III were retrospectively reviewed. Lymph node stations were grouped together into six "zones": peripheral or hilar for N1 and upper or lower mediastinal, aortopulmonary, and subcarinal for N2. Survival was analyzed according to the proposed subdividing N descriptors: single-zone N1 (N1a), multizone N1 (N1b), single-zone N2 (N2a), and multizone N2 (N2b). RESULTS: The 5-year survival rate was 63.8% for N0, 42.3% for N1a, 36.5% for N1b, 35.8% for N2a, and 17.4% for N2b. There were three distinct prognostic groups for N1 and N2 nodes: N1a, N1b or N2a, and N2b disease. In multivariate analysis, age, sex, type of surgery, T stage, and node status were independent prognostic factors. Hazard ratios versus N0 for N1a, N1b or N2b, N2b, and N3 were 1.577, 2.164, 3.291, and 5.897, respectively. CONCLUSION: Amalgamating lymph node stations into zones and subdividing N descriptors described a significant stepwise deterioration of disease status. Although more studies are needed, the lymph node zone and subdivided N descriptors could be one of step for desirable approach of forthcoming tumor, node, metastasis classification in non-small cell lung cancer.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Park, In Kyu(박인규)
Bae, Mi Kyung(배미경)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
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