Heterogeneity of stage IIIA @entity1149 ( XXXX ) and evaluation of late results of surgical treatment.

@entity1 @entity5 @entity957 @entity1149 @entity152 @entity3 @entity420
AIMS: The aim of the study was assessment of the heterogeneity of stage IIIA @entity1149 ( @entity1149 ) and the late results of surgical treatment. METHODS: The study group consisted of 83 consecutive @entity1 discharged between 1988 and 1992 undergoing radical operative treatment for stage IIIA @entity1149 . @entity957 was diagnosed in 54 (65.1%) @entity1 , @entity420 in 23 (27.7%), @entity152 in 2 (2.4%) and mixed (i.e. adenoid-squamous type) in 4 (4.8%). In respect of pTNM staging, 19 (22.9%) @entity1 had T3N1M0, 35 (42.2%) had T2N2M0 and 29 (34.9%) had T3N2M0. RESULTS: Overall, 13.3% of @entity1 with stage IIIA @entity1149 survived 5 years following the operation and 8.7% survived 10 years. Analysis of follow-up study indicated that this group was heterogenic. In T3N1M0 group 26.3% survived 5 years following the operation, in T2N2M0 group 14.3%, in T3N2M0 group 3.5% (P = 0.015). Of 23 @entity1 with N2 disease and no @entity3 in hilar lymph nodes ('skip' @entity3 ), 26.1% survived 5 years, whereas none of 41 @entity1 with @entity3 spreading by continuity survived (P = 0.0015). If mediastinal lymph node @entity3 were diagnosed in one level, 25% @entity1 survived 5 years, but if two or more levels were affected, 2.3% only (P = 0.0214): 85.7% of @entity1 with well-differentiated (G1) @entity5 survived 5 years and 62.0% 10 years, whereas among those with moderately @entity5 , 11.8% and 8.8%, respectively. No @entity1 survived 5 years after resection of poorly differentiated (G3) @entity5 (P < 0.001). CONCLUSIONS: (1) @entity1 operated for stage IIIA @entity1149 are a heterogeneous group, which makes it difficult to predict late results. (2) @entity1 operated for stage IIIA @entity1149 have a better prognosis if @entity3 are discovered in level one mediastinal lymph nodes, particularly in the superior part of mediastinum, or if 'skip' @entity3 (pulmonary hilus unaffected) are discovered, as compared to those with N2 disease. (3) Poor histologic differentiation of the @entity5 is a bad prognostic factor.
