The important prognostic factor about the intrathoracic dissemination of the disease is the level of mediastinal lymph node invaded by the tumor. We aimed to determine the properties of positive mediastinal lymph nodes, the prognostic factors affecting survival and the survival rate after resections. Between December 1, 1993 and June 3, 2001, medical records of 575 patients who underwent resection for non-small cell lung cancer (NSCLC) were retrospectively examined. Eighty-one patients (41.1%) with N2 disease was accepted as the study group. In the study group, 5 patients (6.1 %) were excluded, because of mortality within the postoperative 30 days and 76 patients were evaluated postoperatively. There were 74 men (94.7%) and 2 women (5.3%) with a mean age of 57.5 years (range, 35-74 years). Tumor was located to right lung in 49 patients (44.5%), to left lung in 27 patients (35.5%). Thirty-nine patients underwent pneumonectomy (51.3%), 27 were treated with lobectomy (35.5%), and 10 had bilobectomy (13.2%). The most frequent cell type was epidermoid cancer. Mediastinal lymph node was found to be affected in 57 of patients (75%). The complete resection was performed in 84.2% of patients.

The median survival in one N2 disease patients were 40 months with 3-year and 5-year survival rates as 45% and 34% respectively. On the other hand, in multipl N2 disease median survival were 18 months with a 2-year survival rate as 11% (log rank; 0.04) (p<0.05). No statistically significant effects on survival were observed for age, sex, cell type, T stage, location of the tumor to right or left lung and the type of resection in N2 disease. Mediastinal lymph node invasion is a bad prognostic sign in NSCLC. In this study we found the good prognostic factors as the presence of one N2 disease, the complete resection and the invasion of lymph nodes out of subcarinal node.