Five-year survivors with resected PN2 nonsmall cell lung carcinoma

Mediastinal lymphatic drainage from pulmonary lobe based on CT observations of histoplasmosis: implications for minimal N2 disease of non-small-cell lung cancer

“…In a study of 360 cadavers by Riquet, direct passage to the mediastinal nodes from segmental lymph channels were observed in 20%-40%, 18 which is similar to the incidence of skip metastases from lung cancers. 9,11,12,14,16,24,25 Although we cannot exclude overlooked minimal hilar disease, we argue that skip involvement, especially seen as a single-station disease, mainly refl ects a direct lymphatic pathway to the specifi c mediastinal node-based on the similarity of the incidence in our data to that in an anatomical study. 25 The lymphatic drainage of the right lung can thus be summarized as follows: The upper lobe drains into the right lower paratracheal node (Fig.…”

“…With resected N2 NSCLCs, it has been generally accepted that patients with single-station mediastinal node metastasis have a better prognosis (5-year survival 35%-48%) than those with involvement of multiple mediastinal node stations (5-year survival 11%-18%). 3,7,8,[11][12][13][14][15] Some authors have reported that patients with LUL tumors and a single metastasis to the subaortic lymph node had a good prognosis after complete resection, with a 5-year survival of 42%-63%, and suggested that the subaortic nodes constitute an important pathway of lymph drainage for the left upper lobe and may be equivalent to the hilar lymph nodes. 4,13,14 Similarly, the right paratracheal or tracheobronchial node metastases from RUL tumors are also associated with a good prognosis (5-year survival 48%-60%) compared with other N2 diseases.…”

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Specifi c patterns of mediastinal lymph node metastases in relation with the pulmonary lobe of primary cancer have been reported to be associated with a good prognosis, and the concept of "minimal N2 disease" has been advocated. 4,10,[13][14][15] Anatomically, pulmonary lymphatic drainage to the mediastinum has been assessed using injection techniques. 17,18 However, this technique basically concerns the superfi cial subpleural lymphatics rather than the deep intrapulmonary lymphatics, and the rate of injection may affect the drainage patterns.…”

Clinical significance of skipping mediastinal lymph node metastasis in N2 non-small cell lung cancer

“…Lymph node metastasis is one of the most important prognostic factors for NSCLC patients (12,13). Skipping mediastinal nodal metastasis had been reported in 12-40% of all N2 diseases (8,10).…”

Akciğer kanserinde prognostik faktörler

“…Ancak pN2 hastalar heterojen bir gruptur ve bazı hasta grupları daha iyi prognoza sahiptir [19]. Komplet rezeksiyon uygulanan pN2 hastalarla yapılan çalışmalarda cN0 hastalık, T1 hastalık, yassı hücreli histoloji, hiler metastaz olmadan skip metastaz, etkilenen nodların sınırlı lokalizasyonda olması ve tek bir N2 istasyonda tutulum olması durumunda prognozun rölatif olarak daha iyi olduğu raporlandı [22,39,40]. Ancak bu faktörlerin çoğu cerrahi öncesi bilinememektedir.…”