A Clinical Analysis of Surgical Treatment in Stage III (p-N2) Non-small Cell Lung Cancer

From 1972 to 1986, 596 patients with non-small cell carcinoma of the lung underwent pulmonary resection at Matsudo National Hospital. Of these, relatively curative resection was performed on 77 patients with N2 node metastasis. The 5-year survival rate of these 77 patients was 23.2%. Concerning the histology and T factor, 14 of the 15 T1-patients had adenocarcioma and their 5-year survival rate was 29.5%, but the T2 and T3 cases of adenocarcinoma had poor prognosis and none survived for 5 years. On the other hand, most T3 and T4 patients had squamous cell carcinoma and their 5 -year survival rates were 31.3% and 33.3% respectively. Concerning the site of metastatic N2 nodes, the prognosis of patients with metastasis to the inferior mediastinal and the left aortic lymph nodes was better tnan that of those with metastatic superior mediastinal nodes. In relation of the level of metastatic N2 nodes, the prognosis of patients with metastasis at only one level was better than that of those with metastasis to two levels of nodes or more in squamous cell carcinoma, but this tendency was not observed in patients with adenocarcinoma. Concerning the growth type of metastatic N2 nodes, perinodal growth was rarely seen (21.1%), although it seemed to be slightly more common in squamous cell carcinoma, but the prognosis of these cases was poorer than that of cases with intranodal growth.