Tieqin Liu

Department of Thoracic Surgery, First Hospital, ChinaMedical University

Objective:Patients (pts) with right middle lobenon-small cell lung cancer (NSCLC) were not well studied. This study analyzedthe prognostic factors in resected pathological right middle lobe NSCLC. Method:76 pts with completely resected right middle lobe NSCLC were stratified onage, gender, smoking status, tumor diameter, metastatic status of lymph nodesand histologic subtype. The status of hilar/interlobar lymph nodes was assessedaccording to the seventh edition of the TNM classification for lung cancer.Overall survival (OS) as the primary endpoint was defined as the intervalbetween surgery and death from the tumor or the most recent follow-up. Outcomewas computed using Kaplan-Meier curves and correlation was assessed via Coxregression. Result: The median follow-up was 47 months. Overall,28(36.8%) pts died during follow-up. The 1-, 3- and 5-year overall survivalrates were 90.8%, 71.1% and 47%, respectively. No significant differences werenoted in the age, gender and histologic subtype. There was a trend towardsworse overall survival in those with larger tumor size (P=0.087). Thelymph node metastases and active smoking inversely correlated with OS (50 vs.34 month; P=0.029, respectively). There were 31 pts found to have hilar/interlobarzone lymph nodes metastases. This subgroup included 14 node 2 (N2) pts and 17N1 pts. In N1 possive pts, the median overall survival was 40 months for theHilar/Interlobar zone positive cohort while 32 months for the negative cohort (P=0.123).In multivariate analyses, the presence of lymph node metastases (P<0.001)and smoking status (P=0.031) were revealed to be significant independentprognostic factors. Conclusion: In a single institution cohort, wevalidate lymph nodal involvement and active smoking inversely correlated withOS in resected right middle lobe NSCLC. However, in N1 possive pts, thepresence of Hilar/Interlobar lymph node metastases maybe protective predictorfor survival.

Key Words: Right middle lobeNSCLC  Lymph node metastasis  Hila