[Reevaluation of the surgical indications for lung cancer based on the N factor]

The Standard surgical treatment for stage I, II, and IIIa non-small cell lung cancer (NSCLC) is lobectomy with systemic mediastinal lymph node dissection. More than 50% of our series of 220 patients with cN2 disease were classified as pN0-1. The postoperative 5-year survival rate of patients with cN2 disease was 36%, and that of those with cN2-pN2 disease was 18%. Tumor cell type, surgical technique, or site of tumor had no prognostic significance, although pN, cT, and number of N2 sites were of prognostic significance. We conclude that the indications for surgery are T1-2 N2 disease with a single N2 site.