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Thorac Cardiovasc Surg 2014; 62(02): 103-108
DOI: 10.1055/s-0032-1333067
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Heterogeneity of Clinical N1 Non-Small Cell Lung Cancer

Dohun Kim
1   Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Yong Soo Choi
1   Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Hong Kwan Kim
1   Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Kwhanmien Kim
2   Department of Thoracic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
,
Jhingook Kim
1   Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Young Mog Shim
1   Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
› Author Affiliations
Further Information

Publication History

17 August 2012

13 November 2012

Publication Date:
14 January 2013 (online)

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Abstract

Introduction There have been many reports of N1 node metastasis on computed tomography (CT) scan, but not on positron emission tomography (PET)-CT in nonsmall cell lung cancer. The aim of this study was to analyze the clinicopathologic correlation and survival of N1 disease on preoperative PET-CT.

Methods From January 2003 to December 2007, 1,748 curative lung resections were performed at a single institute. We enrolled 91 patients with clinical N1 on PET-CT. All the enrolled patients had undergone pulmonary resection with mediastinal lymph node dissection. According to the preoperative PET-CT, we classified the patients into two groups: those with single N1 metastasis (cN1a, n = 91) and those with multiple N1 metastases (cN1b, n = 8). Clinicopathologic N staging was compared and survival analysis was performed.

Results Pathologic N2 was found in 19 (19%) patients and was more common in cN1b (4 of 8) than in cN1a group (15 of 91) (p = 0.042). Overall or disease-free survival rate was not different between cN1a and cN1b in the pathologic non-N2 (p = 0.723, 0.905) or in pathologic N2 (p = 0.954, 0.607) subgroups.

Conclusion Clinical N1 on PET-CT is heterogeneous in its pathologic staging and multiple clinical N1 is more related to pathologic N2 than single clinical N1. More cases are needed to show the prognostic significance of multiple clinical N1-pathologic N2.

Keywords

lung cancer - diagnosis (includes staging, imaging, and fiducial) - lung cancer treatment (surgery and medicine) - positron emission tomography
 

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