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Vol.46 No.1 contents

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- Original Article -

Relationship Between Prognosis and Nodal Micrometastasis in Patients With Non-Small Cell Lung Cancer

Kouji Kawaguchi¹, Yasushi Yatabe², Toshiki Okasaka¹, Hideki Endo¹, Haruhiro Yukiue¹, Shoichi Mori¹, Shunzo Hatooka¹, Masayuki Shinoda¹, Tetsuya Mitsudomi¹
Department of ¹Thoracic Surgery, ²Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan

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Objective. We analyzed the relationship between prognosis and size or pattern of lymph node metastases in patients with non-small cell lung cancer. Methods. We evaluated the largest diameter and pattern of lymph node metastases in 201 patients who had undergone at least a lobectomy with dissection of mediastinal lymph nodes for primary lung cancer between January 1996 and December 1998. For patterns of lymph node metastases, we evaluated resected lymph nodes for the presence of sinus permeation (SP), stromal change (SC), and extracapsular invasion (ECI). Results. The pathological status of lymph node metastases was pN0 in 145 patients, pN1 in 20 patients, and pN2 in 36 patients. Micrometastases (mi) as defined between 0.2 mm and 2 mm in largest diameter were detected in 5 patients with pN1 disease and 4 patients with pN2 disease. There was no significant difference (pN1mi vs pN1ma; p=0.439, pN2mi vs pN2ma; p=0.319) between micrometastases and macrometastases (ma). However, among 9 patients with micrometastases, all 4 patients with no SP, SC, or ECI survived more than 4 years without recurrence. Conclusion. Subdividing TNM stage by size and pattern of lymph node metastases would more accurately predict patient prognosis.
key words: Non-small cell lung cancer, Micrometastasis, Pattern of LN metastasis

Received: June 23, 2005
Accepted: December 7, 2005

JJLC 46 (1): 23-26, 2006