Lymph Node Metastatic Patterns Of Curable352 Patients With Non-small Cell Lung Cancer

ObjectiveTo analyze the regularity of mediastinal lymph node metastasis in patients with non-small cell lung cancer(NSCLC)and to provide the basis for the standard mediastinal lymph node dissection.MethodsThree hundred and fifty two patients with NSCLC were enrolled in the study,all patients underwent lobectomy or pneumonectomy, and systemic lymph nodal dissection(SND).The regularity of mediastinal lymph node metastases were analyzed restrospecitively.ResultsTotally there were 6758 stations,a total of 1620 lymph nodes,with an average of 4.6 stations and 19.2 lymph nodes per case, were dissected in the group.One hundred and five cases of mediastinal lymph node metastasis were found pathalogically in 352 NSCLC patients,the metastasis rate was 29.8%.Skip mediastinal lymph node metastasis occurred in 18cases(5.1%) and multi area zones mediastinal lymph node metastasis occurred in 24 cases(6.8%).The right lung cancer had a higher metastasisrate for the No.2R/4R and 7 station,meanwhile left lung cancer were for No.4L,5/6,as well as No.7 station.Upper lobe of lung, lower lobe of the left lung, right upper lobe, right middle lobe and right lung lower lobe NSCLC spread to lobe-specific mediastinal lymph node metastasis rate were 28.2%,20.0%, 30.6% and 34.5%, 17.8%;lobe-nonspecific mediastinal lymph node metastasis rate followed by 9.8%,10.9%, 12.9%, 3.4%, 9.6%.The incidence of mediastinal lymph node metastasis in lung adenocarcinoma was significantly higher than that of lung squamous cell carcinoma(P<0.05).ConclusionBoth location of primary tumor and pathological type,are closely related to mediastinal lymph node metastasis in patients with NSCLC.Due to lobe-nonspecific metastasis in mediastinal lymph node and skipping N2 metastasis are common in the disease,systematic mediastinal lymph node dissection in all zones should be performed rountinely.