Significance of accurate hilar and intrapulmonary lymph node examination and prognostication in stage IA–IIA non-small cell lung cancer, a retrospective cohort study

Abstract Background The examination of lymph nodes (LNs) plays an important role in the nodal staging of non-small cell lung cancer (NSCLC). For patients without LN metastasis, the main role of thorough LN examination is accurate staging, which weakens the effect of staging migration. To date, the role of hilar and intrapulmonary (N1) station LNs has not been fully appreciated. In this study, we aimed to confirm the significance of N1 LNs in long-term survival for stage IA–IIA NSCLC patients and to find the minimum number of LN to examine. Methods The data of patients who underwent radical lobectomy and were confirmed as having non-metastatic LNs from January 2008 to March 2018 were retrospectively screened. Pathology records were reviewed for the number of LNs examined. The Kaplan-Meier method and Cox regression model were used to identify survival and prognostic factors. Results The median number of resected N1 LNs was 8. The number of patients with 0–2 N1 LNs, 3–5 N1 LNs, 6–8 N1 LNs, 9–11 N1 LNs, and more than 11 N1 LNs examined was 181, 425, 477, 414, and 531, respectively. Sex (P = 0.004), age (P < 0.001), tumor size (P = 0.004), differentiation degree (P = 0.001), and number of N1 LNs examined (P = 0.008) were independent prognostic factors of overall survival. Gender (P = 0.006), age (P = 0.031), tumor size (P = 0.001), differentiation degree (P = 0.001), vascular invasion (P = 0.034), and number of N1 LNs examined (P = 0.007) were independent prognostic factors of disease-free survival. Compared with patients with 0–5 N1 LNs examined, patients with more than 5 N1 LNs examined had better OS (P = 0.015) and had better DFS (P = 0.015) if only a landmark 5-year follow-up was performed. Conclusion Increasing the number of N1 LN examination might improve the long-term survival of T1-2N0 NSCLC patients. These data indicate that at least 6 N1 nodes examined is an essential part in surgical and pathological management but cannot prove this. This finding should be confirmed in a large, prospective randomized clinical study.

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Significance of accurate hilar and intrapulmonary lymph node examination and prognostication in stage IA-IIA non-small cell lung cancer, a retrospective cohort study

10.21203/rs.3.rs-23890/v2 ◽

2020 ◽

Author(s):

Wenyu Zhai ◽

Fangfang Duan ◽

Yuzhen Zheng ◽

Qihang Yan ◽

Shuqin Dai ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factors ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Differentiation Degree ◽

Stage Ia ◽

Nsclc Patients

Abstract Background The examination of lymph nodes (LNs) plays an important role in the nodal staging of non-small cell lung cancer (NSCLC). For patients without LN metastasis, the main role of thorough LN examination is accurate staging, which weakens the effect of staging migration. To date, on the role of hilar and intrapulmonary (N1) station LNs has not been fully appreciated. In this study, we aimed to confirm the significance of N1 LNs in long-term survival for stage IA-IIA NSCLC patients and to find the minimum number of LN to examine.Methods The data of patients who underwent radical lobectomy and were confirmed as having nonmetastatic LNs from January 2008 to March 2018 were retrospectively screened. Pathology records were reviewed for the number of LNs examined. The Kaplan-Meier method and Cox regression model were used to identify survival and prognostic factors.Results The median number of resected N1 LNs was 8. The number of patients with 0-2 N1 LNs, 3-5 N1 LNs, 6-8 N1 LNs, 9-11 N1 LNs and more than 11 N1 LNs examined was 181, 425, 477, 414 and 531, respectively. Sex (P=0.004), age (P<0.001), tumor size (P=0.004), differentiation degree (P=0.001) and number of N1 LNs examined (P=0.008) were independent prognostic factors of overall survival. Gender (P=0.006), age (P=0.031), tumor size (P=0.001), differentiation degree (P=0.001), vascular invasion (P=0.034) and number of N1 LNs examined (P=0.007) were independent prognostic factors of disease-free survival. Conclusion Increasing the number of N1 LNs examination might improve the long-term survival of T1-2N0 NSCLC patients. These data indicate that the optimal practice involves examining at least 6 N1 nodes in surgical and pathological management but cannot prove this. This finding should be confirmed in a large, prospective randomized clinical study.

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Significance of accurate hilar and intrapulmonary lymph node examination and prognostication in stage IA-IIA non-small cell lung cancer, a retrospective cohort study

10.21203/rs.3.rs-23890/v3 ◽

2020 ◽

Author(s):

Wenyu Zhai ◽

Fangfang Duan ◽

Yuzhen Zheng ◽

Qihang Yan ◽

Shuqin Dai ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factors ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Differentiation Degree ◽

Stage Ia ◽

Nsclc Patients

Abstract Background: The examination of lymph nodes (LNs) plays an important role in the nodal staging of non-small cell lung cancer (NSCLC). For patients without LN metastasis, the main role of thorough LN examination is accurate staging, which weakens the effect of staging migration. To date, on the role of hilar and intrapulmonary (N1) station LNs has not been fully appreciated. In this study, we aimed to confirm the significance of N1 LNs in long-term survival for stage IA-IIA NSCLC patients and to find the minimum number of LN to examine.Methods: The data of patients who underwent radical lobectomy and were confirmed as having nonmetastatic LNs from January 2008 to March 2018 were retrospectively screened. Pathology records were reviewed for the number of LNs examined. The Kaplan-Meier method and Cox regression model were used to identify survival and prognostic factors.Results: The median number of resected N1 LNs was 8. The number of patients with 0-2 N1 LNs, 3-5 N1 LNs, 6-8 N1 LNs, 9-11 N1 LNs and more than 11 N1 LNs examined was 181, 425, 477, 414 and 531, respectively. Sex (P=0.004), age (P<0.001), tumor size (P=0.004), differentiation degree (P=0.001) and number of N1 LNs examined (P=0.008) were independent prognostic factors of overall survival. Gender (P=0.006), age (P=0.031), tumor size (P=0.001), differentiation degree (P=0.001), vascular invasion (P=0.034) and number of N1 LNs examined (P=0.007) were independent prognostic factors of disease-free survival. Compared with patients with 0-5 N1 LNs examined, patients with more than 5 N1 LNs examined had better OS (P=0.015) and had better DFS (P=0.015) if only a landmark 5-year follow-up was performed.Conclusion: Increasing the number of N1 LNs examination might improve the long-term survival of T1-2N0 NSCLC patients. These data indicate that the at least 6 N1 nodes examined is an essential part in surgical and pathological management but cannot prove this. This finding should be confirmed in a large, prospective randomized clinical study.

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Significance of accurate hilar and intrapulmonary lymph nodes examination in stage IA-IIA non-small cell lung cancer, a retrospective cohort study

10.21203/rs.3.rs-23890/v1 ◽

2020 ◽

Author(s):

Wenyu Zhai ◽

Fangfang Duan ◽

Yuzhen Zheng ◽

Qihang Yan ◽

Shuqin Dai ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Lymph Nodes ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Differentiation Degree ◽

Stage Ia ◽

Nsclc Patients

Abstract Background The examination of lymph node plays an important part in the nodal staging of non-small cell lung cancer (NSCLC). Till present, on the role of hilar and intrapulmonary (N1) station lymph node (LN) examined is not fully appreciated. In this study, we aimed to confirm the significance of N1 lymph node examined in the long-term survival for stage IA-IIA NSCLC patients and find the minimum number of lymph nodes.Methods The data of patients who underwent radical lobectomy and confirmed as lymph node non-metastatsized from January 2008 to March 2018 were retrospectively screened. Pathology records were reviewed for the number of lymph nodes examined. Kaplan-Meier method and Cox regression model were used to identify survival and prognostic factors.Results The median number of resected N1 LNs was 8. The number of patients with 0-2 N1 LNs, 3-5 N1 LNs, 6-8 N1 LNs, 9-11 N1 LNs and more than 11 N1 LNs examined was 181, 425, 477, 414 and 531, respectively. Gender (P=0.004), age (P<0.001), tumor size (P=0.004), differentiation degree (P=0.001) and the number of N1 LNs examined (P=0.008) were the independent prognostic factors of overall survival. Gender (P=0.006), age (P=0.031), tumor size (P=0.001), differentiation degree (P=0.001), vascular invasion (P=0.034) and the number of N1 LNs examined (P=0.007) were the independent prognostic factors of disease-free survival. Conclusion Increasing the number of N1 LNs examination could improve the long-term survival of T1-2N0 NSCLC patients. At least six LNs should be examined in surgical and pathological management.

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PUB084 Long Term Survival of Stage IIIb Non-Small Cell Lung Cancer (NSCLC) Patients Treated with Concurrent Chemoradiation

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2016.11.2054 ◽

2017 ◽

Vol 12 (1) ◽

pp. S1496

Author(s):

Tahir Mehmood

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Stage Iiib ◽

Concurrent Chemoradiation ◽

Small Cell Lung ◽

Term Survival ◽

Nsclc Patients

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Prognostic factors for long term survival in small cell lung cancer (SCLC)

Lung Cancer ◽

10.1016/0169-5002(93)90638-e ◽

1993 ◽

Vol 8 (5-6) ◽

pp. 359

Author(s):

E. Senkus ◽

J. Jassem ◽

H. Karnicka-Młodkowska ◽

A. Badzio ◽

E. Wiatr ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factors ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Long Term Survival

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Long-term outcomes of video-assisted lobectomy in non-small cell lung cancer

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492321997380 ◽

2021 ◽

pp. 021849232199738

Author(s):

Tran Minh Bao Luan ◽

Ho Tat Bang ◽

Nguyen Lam Vuong ◽

Le Tien Dung ◽

Nguyen Trung Tin ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factors ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Small Cell Lung ◽

Long Term Outcomes ◽

Term Survival ◽

Video Assisted

Background Video-assisted thoracoscopic surgery lobectomy combined with lymphadenectomy is widely utilized worldwide for treating non-small cell lung cancer. We evaluated the long-term survival outcomes of this approach and determined the prognostic factors of overall survival. Methods This prospective observational study was performed in patients with non-small cell lung cancer who were subjected to video-assisted lobectomy and lymphadenectomy from 2012 to 2016. Independent prognostic factors were determined via uni- and multivariable Cox models. Results There were 109 patients with the mean age of 59.2 years and males accounted for 54.1%. Postoperative staging determined 22.9% of stage IA, 31.2% of stage IB, 16.5% of stage IIA and 29.4% of stage IIIA. Median follow-up time was 27 months. The overall survival rate after 1, 2, 3, 4 and 5 years was 100%, 85.9%, 65.3%, 55.9% and 55.9%, respectively. In univariable analysis, smoking (hazard ratio (HR) [95% confidence interval (CI)]: 2.50 [1.18–5.31]), Tumor--nodes--metastases (TNM) stage (IIA: 7.60 [1.57–36.9]; IIIA: 14.3 [3.28–62.7] compared to IA), histological differentiation (moderately differentiated: 4.91 [1.04–23.2]; poorly differentiated: 8.25 [1.91–35.6] compared to well differentiated), lymph node size ≥1 cm (8.22 [3.11–21.7]), tumour size ≥3 cm (4.24 [1.01–17.9]), radical lymphadenectomy (6.67 [3.14–14.2]) were identified as prognostic factors of the long-term survival. In multivariable analysis, only radical lymphadenectomy was an independent prognostic factor (HR [95% CI]: 3.94 [1.41–11.0]). Conclusion Video-assisted thoracoscopic lobectomy combined with lymphadenectomy is feasible, safe and effective for the treatment of non-small cell lung cancer. The long-term outcomes of this method are favourable, especially at the early stage of cancer.

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