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Z.X. Kang

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    P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P1.03-006 - Survival Analysis of 121 Cases of Stage III A (N2) Non-Small Cell Lung Cancer Treated with Surgery Resection (ID 2673)

      09:30 - 17:00  |  Author(s): Z.X. Kang

      • Abstract

      Lung cancer is the leading cause of both morbidity and mortality related to cancer worldwide. The most controversial academic strategies for the treatment of lung cancer is ⅢA-N2 non-small cell lung cancer.This study was a retrospective analysis of the clinical features of stage ⅢA-N2 patients, in order to find the factors that affecting long-term survival in the postoperative patients of stage ⅢA-N2 NSCLC.

      One thousand two houndred and ningtyLung cancer patients from a prospectively maintained database, treated by a single surgeon group between January 2000 and Jun 2013, at Beijing Cancer Hospital, Peking University, were reviewed.121 patients of stage ⅢA-N2 NSCLCs were analyzed, comparing gender, age, smoking index, perioperative chemotherapy, surgical approach, histological type, intravascular cancer emboli, pT stage and N2 lymph node status with long-term survival.

      The postoperative pathological findings in this group showed that 79 patients(65.3%) were single-station N2, 42 patients (34.7%, 30 patients had 2 stations N2, 8 patients had 3 stations N2, 4 patients had 4 stations N2) were multi-stations N2; 42 patients’ (34.7%) N2 status were ⅢA1/A2, and 79 patients (65.3%) N2 status were ⅢA3/A4; 54 patients (44.6%) had subcarinal lymph node metastasis. The overall 1,3,5-year survival rates of 121 patients was 91.7%, 62.2%, 43.6%, respectively, and the median survival time was 50.3 months. Univariate analysis showed that the 1,3,5-year survival rates between single-station N2 and multi-station N2 metastasis was 94.9% vs. 85.5%, 70.3% vs. 46.7%, 58.3% vs. 25.5% respectively, with a significant difference (p= 0.001); the 1,3,5-year survival rates between ⅢA1/A2 and ⅢA3/A4 was 97.6% vs. 88.5%, 78.3% vs. 53.5%, 52.7% vs. 38.4% respectively, with a significant difference (p=0.020); subcarinal lymph node metastasis was not a prognostic factor, the 1,3,5-year survival rates between metastesis and no metastasis was 92.6% vs. 91.0%, 56.0% vs. 68.4%, 37.4 vs. 49.5% respectively, with no significant difference (p=0.276). Gender, age, smoking index, perioperative chemotherapy, T stage, histological type, intravascular cancer emboli and other factors are not prognostic factors in this group. COX regression analysis showed that only single station N2 metastasis(HR=0.326,95%CI:0.186~0.572)and IIIA1/A2(HR=0.494,95%CI:0.259~0.941)were the independence factors.

      1. After a rigorous selection of stage ⅢA-N2 NSCLC, patients obtain good prognosis by surgery combined with multidisciplinary treatment. 2. Single-station N2 metastasis had a better survial comparing to multi-station N2 metastasis. 3. The dicovery of pathology of N2 metastasis in intraoperative or postoperative pathological findings (ⅢA1/A2) had a better survival comparing to pretreatment fingdings(ⅢA3/A4). 4. Subcarinal lymph node metastasis was not ⅢA-N2 indicator of poor prognosis in NSCLC. 5. Gender, age, surgical approach, histological type, pT staging does not affect the stage ⅢA-N2 NSCLC prognosis.