The Impact of Multiple Metastatic Nodal Stations on Survival in Patients With Resectable N1 and N2 Nonsmall-Cell Lung Cancer

Prognostic Significance of the Number of Metastatic pN2 Lymph Nodes in Stage IIIA-N2 Non–Small-Cell Lung Cancer After Curative Resection

“…Staging according to skip mediastinal metastasis (determined by the presence of concomitant pN1 disease) and metastatic pN2 station (determined by the number of metastatic pN2 stations) has also been investigated and showed a correlation with prognosis in multiple retrospective studies. 1,[9][10][11][12][19][20][21] Although skip mediastinal metastasis did not show significant association with survival outcomes, metastatic pN2 stations was an independent prognostic factor for DFS and OS in our study. However, the magnitude of impact of the number of metastatic pN2 lymph nodes on DFS and OS (ie, HR) was greater than that of the metastatic pN2 station.…”

The Number of Lymph Node Metastases as a Prognostic Factor in Patients With N1 Non-small Cell Lung Cancer

“…[9][10][11] Research evaluating the number of positive LNs as a new prognostic factor in N1 NSCLC has shown confl icting results. 5,7,8,12,22 Using similar groupings as ours, Marra et al 7 found an association, in univariate but not in adjusted analysis, between the number of positive nodes and survival in a cohort of patients with resected N1 NSCLC from a single referral center.…”

“…Some prior studies have suggested a potential association between the number of positive LNs and survival in these patients. [7][8][9][10][11][12] However, many of these studies were limited to small cohorts of patients from single institutions and only assessed the impact of single vs multiple LN involvement. [9][10][11] Other studies combined patients with N1 and N2 disease, making it diffi cult to extrapolate their results to N1 disease alone.…”

“…[9][10][11] Other studies combined patients with N1 and N2 disease, making it diffi cult to extrapolate their results to N1 disease alone. 8,12 Because of these limitations, the number of N1 nodes has not been adopted as a prognostic factor in clinical practice.…”

Prognostic value of single nodal zone metastasis in non-small-cell lung cancer☆

“…Recent reports have demonstrated that patients with some subgroups of N2 disease, such as single station N2 metastasis, microscopic metastasis and left upper lobe tumours with subaortic metastasis, have shown better survival than others after surgical resection. The extent of lymph node metastasis is well known as an important prognostic factor, and the prognosis becomes worse with an increasing number of involved nodal stations or lymph nodes [8][9][10][11][12]. However, intra-operative designation of each nodal station might be difficult and confusing because of the adjacency of the nodal stations, especially in the case of the right upper and lower paratracheal nodes.…”