Postoperative Prognosis Of Stage ⅢA-N2 NSCLC

Purpose: To analyze the factors that influence the prognosis of patients with stage ⅢA-N2 NSCLC,and to provide a theoretical basis for the clinical guidance of standardized diagnosis and treatment of stage ⅢA-N2 NSCLC.Methods: A retrospective analysis of 82 patients with stage ⅢA-N2 non-small cell lung cancer who underwent surgery from January 2014 to December 2014 in our hospital was performed.The receiver operating characteristic curve(ROC)was used to detect the occurrence of recurrence or metastasis for the postoperative lung cancer with mediastinal lymph node of different diameters and to find the boundary value of mediastinal lymph nodes.After the grouping of the threshold value,they were analyzed together with other factors to determine the prognosis of lung cancer surgery.The Kaplan-Meier method was used to analyze the survival rate and draw the survival curve.The univariate analysis was performed according to the Log-rank test.Factors that have statistically significant univariate or differential trends are analyzed by the COX proportional hazards regression model.Results: The 3-year survival rate of 82 patients with stage ⅢA-N2 NSCLC was29.4%,and the median survival time was 32.9 months.The critical value of mediastinal lymph nodes was found to be 2.2cm(sensitivity 81.9%,specificity 60%)by ROC curve.According to this cut-off grouped study,it was found that the 3-year survival rate was 32.1% in the LN<2.2cm group,and the 3-year survival rate was22.1% in the LN≥2.2cm group,and the median survival time was 33.9 months and23.7 months,respectively(P=0.032).Univariate analysis showed that vascular invasion,postoperative adjuvant therapy,metastasis N2 size,level of metastatic lymph nodes,and number of metastatic lymph nodes were factors influencing survival prognosis.Multivariate analysis showed that the number of metastatic lymph nodes(HR=0.488,P=0.006)and vascular invasion(HR=0.417,P=0.005)were independent factors influencing the survival of patients with stage ⅢA-N2non-small cell lung cancer.Conclusions: 1.The diameter of mediastinal lymph nodes had a significant effect on the OS of stage ⅢA-N2 NSCLC postoperatived,and had no significant effect on DFS.The prognosis of lung cancer with N2 lymph node ≥2.2cm was poor after surgery,and the comparison with the efficacy of concurrent chemoradiation for lung cancer in this stage is worthy of further study;2.the number of metastatic lymph nodes and vascular invasion had an effect on OS of stage ⅢA-N2 NSCLC postoperatived,and had no significant effect on DFS,and both are independent prognostic factors.