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  P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

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    P1.16-55 - Surgical Treatment for Lung Cancer. Subaortic (Para-Aortic) Lymph Nodes Involvement - N1 or N2 Disease? (ID 13693)

    16:45 - 18:00  |  Presenting Author(s): Magdalena Szczęsna
    • Abstract
    • Slides

    Background
    

    In patients with cN2 disease surgical treatment alone is not recommended because it often indicates systemic disease. Qualification to undergo a surgery patients with clinical manifestation of subaortic (#5)/para-aortic (#6) nodes malignant involvement remains controversial. The aim of this study is to compare survivals of patients with single station metastases to #5(#6) lymph nodes, patients with interlobar (#11) and lobar (#12) nodes involvement (pN1) and patients with right lower paratracheal (#4R) and subcarinal (#7) nodes involvement (pN2) after received lung resection.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Material was collected rectospectively from an online-survey-based database of the Polish Lung Cancer Group and included patients who underwent a surgical treatment due to lung cancer at multi-institution in Poland between 2007 and 2017. The 8th Edition of the Staging Classification System (TNM, 2017) was used to determine staging.

    4c3880bb027f159e801041b1021e88e8 Result
    

    There were 34 870 patients (35,52% females and 64,48% males) who received surgical treatment for lung cancer. 27 321 (78,35%) underwent lobectomy, 1 063 (3,04%) segmentectomy, 4 658 (13,35%) pneumonectomy, 1 768 (5,07%) wedge resection. Histologic types included: non-small cell lung cancer (n= 475), adenocarcinoma (n=13 515), squamous cell carcinoma (n=14 273), large cell carcinoma (2 127), carcinoid (n=1 428) and others (n=2 934). Stage IA1 disease presented 683 (1,97%) patients, IA2 - 4442 (12,79%), IA3 - 3674 (10,58%), IB - 7150 (20,59%). Stage IIA disease presented 2493 (7,18%) patients, IIB - 7442 (21,43%). 6804 (19,59%) patients were in stage IIIA disease, 1529 (4,4%) in IIIB and 475 (1,37%) in IVA, 12 (0,03%) in IVB disease. The majority of patients were diagnosed with N0 disease (n: 24388, 70,23%). N1 disease was reported in 5913 (17,03%) cases, N2 disease in 4 412 (12,71%).

    Among patients with N1 disease there were 3543 cases with confirmed metastases only in #11 or #12 nodes. 3-, 5-, 7- and over 7-year survivals in this group were 70,03%, 15,33%, 8,41%, 6,24%. Among patients with N2 disease there were 1202 cases with exclusive involvement of #4R or #7 nodes. 3-, 5-, 7- and over 7-year survivals in this group were 73,21%, 14,14%, 7,74%, 4,91%. Malignant involvement of #5 or #6 nodes were reported in 1047 cases. 3-, 5-, 7- and over 7-year survivals here were 75,17%, 14,04%, 6,59%, 4,2%.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    According to the study there is no significant difference in survival of patients with #5(6) nodes invasion comparing to those with N2 and N1 disease. Controversy followed from classification #5(6) nodes as N2 remains unsettled.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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