ASO Author Reflections: Survival Impact of N2 in Non-small Cell Lung Cancer

Excerpt

Lung cancer is the leading cause of death by cancer in the world, and its incidence is still rising. Among 80% of the patients with a diagnosis of non–small cell lung carcinoma (NSCLC), adenocarcinoma is the main histologic type, followed by squamous cell carcinoma, large cell carcinoma, and undifferentiated carcinoma, according to the World Health Organization (WHO) classification.1 For 20% of lung cancer patients with disease diagnosed at an advanced stage (stages 3B and 4), surgery can be performed with curative intent. Among these patients, lymph node dissection is very important, and lymph node (N0–N3) status is a prognostic factor. The worst prognostic factor is associated with N2 and N3. Furthermore, N2 status in NSCLC is heterogeneous because it compares subcarinal station (station 7) and Barety’s station (station 4) node disease and has a global prognosis with a 23% survival rate at 5 years.2 In a retrospective study,3 the authors addressed the question of a possible specific prognosis for N2 in different locations (locations 4 and 7) for 342 patients with NSCLC undergoing surgery. …