Prognostic factors in resected non-small cell lung cancer with pathological N1 lymph node involvement: a survival analysis

BACKGROUND: This study aimed to evaluate the prognostic factors influencing survival in patients who underwent surgical treatment for early-stage non-small cell lung cancer (NSCLC) and were found to have N1 lymph node metastasis on pathological examination. METHODS: A total of 66 NSCLC patients who underwent anatomic lung resection (lobectomy, bilobectomy, or pneumonectomy) at our clinic between 2010 and 2020 and had a pathological stage of T1-2N1M0 disease were retrospectively analyzed. Clinical, demographic, histopathological, and surgical data, as well as survival times, were evaluated. Survival analyses were performed via the Kaplan-Meier method, and prognostic variables were assessed via univariate and multivariate analyses. RESULTS: A total of 66 patients, 60 males and 6 females, were included in the study. The mean age was 63.7 ± 8.3 years. The mean overall survival was 59.7 months, and the disease-free survival was 52.0 months. Squamous cell carcinoma histology, central tumor location, the presence of occult lymph node metastasis, and visceral pleural invasion were significantly associated with survival (p < 0.05). Cox regression analysis revealed that the histological subtype and the visibility of N1 metastasis were identified as independent prognostic factors. CONCLUSION: Pathological N1 lymph node involvement has a significant effect on the prognosis of patients with NSCLC. In particular, histological subtype and the presence of occult metastasis are key determinants of survival.