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Survival and Prognostic Factors in Resected cN 2-pN 0 Non-small Cell Lung Cancer

Surgery remains the treatment of choice for controlling pathologic grade N0 (pN0) non-small cell lung cancer (NSCLC). Although many patients achieve long-term survival, a significant proportion suffer local, regional or distant recurrence, and the 5-year survival rates after resection of pN0 disease range from 38% (T3N0) to 67% (T1N0). The use of multimodality therapy to treat earlystage NSCLC is now under investigation. Thus, surgeons need to be certain that the lesions are staged accurately to determine the most appropriate treatment plan. The problem is that although many prognostic factors have been described, many determinants cannot be known with certainty until after resection. Therefore, the identification of prognostic factors which can be determined preor at least intraoperatively is needed to individualize treatment for maximal efficacy. We recently have identified prognostic factors in 40 patients with cN2-pN2 disease who underwent resection. We concluded that surgery prolongs survival in patients with cN2-pN2 disease only when specific favorable prognostic factors are present. This report focuses on prognostic factors which were determinable preor intraoperatively in 45 patients with cN2-pN0 disease who underwent resection. The role of surgery in this subgroup of patients is discussed.