Clinical significance of lymph node metastases in non-small-cell lung cancer

Between 1986 and 1991, there were 79 patients with non-small cell lung cancer who underwent lobectomy, or pneumonectomy with ipsilateral intrathoracic lymph node dissection by the same surgical team in this hospital. There were 70 men and 9 women whose mean age were 65.1 years, with a range from 19 to 84 years. The tumor stages were distributed as follows: Stage I, 39 patients (49.38%); Stage II, 7 patients (8.86%); and Stage IIIa, 33 patients (41.76%). The operation modes consisted of 48 lobectomies, 12 bilobectomies, 18 pneumonectomies, and one sleeve lobectomy. The rates of operative morbidity and mortality were 7.6% and 5.0%, respectively. The major causes of operative mortality were related to cardiac and pulmonary complications. The cumulative 5-year survival rate was 78% for Stage I patients, 47% for Stage II patients, and 19% for Stage IIIa patients, respectively. The average number of dissected lymph nodes was 23.1 for each patient. The incidence distribution of nodal involvement in patients with epidermoid carcinoma did not differ from those with adenocarcinoma. However, the incidence of skip metastasis was significantly higher in patients with epidermoid carcinoma than those with adenocarcinoma (20% vs 5.7%, P