Future Classification of Nodal Factor: Based on Anatomical Location or Number of Lymph Nodes Metastasis

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  • Saji Hisashi
    Division of Thoracic Surgery, Department of Surgery, Tokyo Medical University
  • Ikeda Norihiko
    Division of Thoracic Surgery, Department of Surgery, Tokyo Medical University

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  • N因子分類（解剖学的位置と転移個数）の方向性

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Introduction. Since the publication of the UICC 7th TNM classification, the Naruke-Japanese Map and MD-ATS Map were united to form the IASLC Map, and the border between the N1 and N2 locations was clarified. However, it is still unknown whether this borderline is associated with the outcome of non-small cell lung cancer (NSCLC). Meanwhile, the total number of involved lymph nodes (LNs) has recently been shown to be a prognostic factor and is one of the parameters of the N factors in the present TNM classification of colorectal cancer, bladder cancer and head and neck cancer. In the present study, we retrospectively investigated whether the total number or anatomical location of involved LNs is superior prognostic factor in NSCLC. Patients and Methods. From 2000 to 2007, 1311 patients received surgical resection for primary lung cancer at Tokyo Medical University. After excluding patients who received induction therapy, incomplete resection, or who had a histological diagnosis of small cell lung cancer, a series of 928 consecutive NSCLC patients who underwent complete lobectomy, bilobectomy or pneumonectomy with LNs dissection were eligible. Log-rank and Cox proportional hazard models were used to estimate survival rates and relative risks. Results. Patients with pN1 with a total number of involved LNs of more than 4 tended to have a worse outcome compared with patients with pN2 and 1-3 LN metastasis. Conclusion. The total number of involved LNs better indicated the outcomes of NSCLC patients compared with the anatomical location of involved LNs only in our series. Further validation studies are warranted.<br>

Journal

  • Haigan

    Haigan 52 (1), 61-67, 2012

    The Japan Lung Cancer Society

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