Relationship between the Location of Primary Tumor and Level of Mediastinal Lymph Node Metastases and the Prognosis of Resected Non-small Cell N₂ Lung Cancer

Abstract

The authors analyzed the relationship between the location of primary tumor and level of mediastinal lymph node metastases and the prognosis in resected non-small cell lung cancer with mediastinal lymph node metastases. The frequency of mediastinal lymph node metastases in tumors in the upper lobe was higher in the upper mediastinal lymph nodes (mostly the lower paratracheal in the right and the subaortic in the left) and in the lower lobe the frequency was higher in the subcarinal lymph node. The majority of the number of positive levels in mediastinal lymph node was one positive level and there was no significant difference in frequency between tumors in the upper lobe and those in the lower lobe. In patients who had undergone curative operations, the survival rate of tumors in the lower lobe (7.8% at 5 years) was less (P<0.01) than that of tumors in the upper lobe (36.7% at 5 years). The results suggest differences in the mode of mediastinal lymph node metastases according to the location of primary tumor influences the prognosis.