Risk Factors for Lymph Node Metastasis in Clinical Stage IA3 Lung Adenocarcinoma Patients

Abstract Background: lymph node metastasis is a poor prognostic factor for lung cancer; however, the risk of lymph node metastasis has not been clarified yet, so it is controversial to conduct systematic lymph node dissection for early lung cancer. Therefore, this study aimed to focus on analyzing the predictive factors for lymph node metastasis in patients with clinical stage IA3 lung adenocarcinoma.Methods: Our study group retrospectively analyzed all surgical patients admitted to our hospital from January 1, 2017 to June 2021, and these patients were considered having stage IA3 lung adenocarcinoma. A total of 334 patients underwent lobectomy combined with systematic lymph node dissection. Univariate and multivariate logistic regression analysis were adopted to predict the risk factors of lymph node metastasis.Results: Among the 334 patients eligible for this study, the overall mediastinal lymph node metastasis rate was 15.27%. There were 45 cases of N1 metastasis and 11 cases of N2 metastasis, 5 cases had both N1 and N2 metastasis at the same time. The patients were divided into three groups according to consolidation tumor ratio (CTR) values (<0.25, 0.25-0.5, >0.5). The lymph node metastasis rates in each CTR group were 1.8% (2/112), 11.7% (17/145) and 41.6% (32/77), respectively. The mediastinal lymph node metastasis rate in patients with carcinoembryonic antigen (CEA>5ng/ml) was 57.89% (22/38). The receiver operating characteristic curve (ROC) showed that the area under the curve (AUC) of CTR, pathological type and CEA were 0.790 [95% confidence interval (CI): 0.727 – 0.853，P<0.001]; 0.800（95% CI:0.735–0.865，P<0.001）;0.682（95% CI: 0.591–0.773, P<0.001）;respectively. Multivariate regression analysis showed that these listed factors were significantly correlated with lymph node metastasis of clinical stage IA3 lung adenocarcinoma: CEA [Odds Ratio (OR)=3.05, P=0.016], CTR 0.25 to 0.5 (OR=14.12, P<0.017), CTR>0.5 (OR=7.75, P=0.015), micropapillary adenocarcinoma (OR=15.704, P<0.001), and solid adenocarcinoma (OR=8.971, P=0.001).Conclusions: CEA (>5ng/ml), histologic subtype and CTR (>0.25) are important predictors of lymph node metastasis in clinical stage IA3 lung adenocarcinoma, systematic lymph node dissection should be the prior choice for patients with clinical stage IA3 incorporated with risk factors. The lymph node dissection method in stage IA3 should be alternative from those in stage IA1 and IA2.

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Clinical Analysis of Cervical Lymph Node Metastasis Risk Factors and the Feasibility of Prophylactic Central Lymph Node Dissection in Papillary Thyroid Carcinoma

International Journal of Endocrinology ◽

10.1155/2021/6635686 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Yifan Chen ◽

Shuo Chen ◽

Xiaoying Lin ◽

Xiangqing Huang ◽

Xiaofang Yu ◽

...

Keyword(s):

Risk Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Node Dissection ◽

Cervical Lymph Node Metastasis ◽

Node Dissection ◽

Central Lymph Node ◽

Central Lymph Node Dissection ◽

Node Metastasis ◽

Central Lymph

Objective. To identify the risk factors for cervical lymph node metastasis (CLNM) and the feasibility of prophylactic central lymph node dissection. Methods. The characteristics of 1107 patients were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with lymph node metastasis. The relationship between the central lymph node dissection (CLND) and lateral lymph node metastasis (LLNM) was analyzed using the correlation analysis. Results. The probability of CLNM was closely related to the male gender, age <55, and the increase of tumor size. Those patients with an increase in tumor size and CLNM were extremely prone to LLNM. Also, LLNM was more likely to happen in those with the more positive central lymph nodes. Routine prophylactic central lymph node dissection (P-CLND) did not increase the risk of complications. Conclusion. P-CLND should be considered as a reasonable surgical treatment for PTC.

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Long non-coding RNA SPRY4-IT1 as a promising indicator for three field lymph-node dissection of thoracic esophageal carcinoma

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01433-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Peng Qie ◽

Qifan Yin ◽

Xuejiao Xun ◽

Yongbin Song ◽

Shaohui Zhou ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Node Dissection ◽

Mediastinal Lymph Node ◽

High Expression ◽

Expression Level ◽

Node Dissection ◽

Node Metastasis ◽

T Classification

Abstract Background Esophageal squamous cell carcinoma(ESCC) is one of the most common tumors worldwide. Esophagectomy with three-field lymph node dissection(3FLND) is the radical surgical procedure for esophageal cancer. However, 3FLND is not widely used due to it’s higher mortality rate and higher incidence of postoperative complications. There is an urgent need to identify novel biomarkers that can guide the most proper lymph-node dissection in esophageal cancer patients. Method Ninety-two patients with thoracic ESCC undergoing 3FLND were enrolled into our study from the Department of Thoracic Surgery of the Fourth Hospital affiliated to the Hebei Medical University and Hebei General Hospital between Jun 2011 and Dec 2015. Retrospectively collected data from these 92 patients was used to explore the relationship between the lymph-node metastasis、recurrence and the SPRY4-IT1 expression level and to determine whether 3FLND should be performed in patients with thoracic ESCC. Results The findings revealed that the SPRY4-IT1 expression was significantly higher in esophageal cancer tissues than in adjacent noncancerous tissues. (P < 0.01). Furthermore, the high expression of SPRY4-IT1 was significantly correlated with tumor differentiation (P = 0.029), T classification (P = 0.013), lymph node metastasis(P = 0.022) and pathological stage (P = 0.001). The increased expression of SPRY4-IT1 was associated with a higher risk of cervical and superior mediastinal lymph-node metastasis(P = 0.039).However, no significant association was observed between the risk of cervical and superior mediastinal lymph-node recurrence and the SPRY4-IT1 expression level in the thoracic ESCC patients performed 3FLND(P = 0.509). Conclusions Our data support the assumption that the high expression of SPRY4-IT1 is associated with a high risk of lymph node metastasis and it has potential application as a indicator for guiding on three-field lymph node dissection in patients with thoracic ESCC. Randomized controlled trials with a large cohort of patients will be needed to confirm this conclusion in the future.

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The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer

International Journal of Surgical Oncology ◽

10.1155/2011/814649 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Nikki L. Neubauer ◽

John R. Lurain

Keyword(s):

Risk Factors ◽

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Node Dissection ◽

Myometrial Invasion ◽

Surgical Staging ◽

Node Dissection ◽

Node Metastasis ◽

Gynecology And Obstetrics

Surgical staging, including lymph node sampling, for endometrial cancer was adopted by the International Federation of Gynecology and Obstetrics (FIGO) in 1988 based on reports demonstrating diagnostic and therapeutic advantages. This review focuses on the incidence of lymph node metastasis, risk factors for lymph node involvement, the effect of lymph node metastasis on prognosis, the therapeutic effect and diagnostic usefulness of lymphadenectomy, risks of lymph node dissection, and future directions in surgical staging of endometrial cancer. Surgical staging identifies most patients with extrauterine disease as well as uterine risk factors for recurrence, thereby allowing for a more informed approach to postoperative adjuvant therapy. Lymphadenectomy as a part of surgical staging is not required in patients assessed intraoperatively to be at low risk for lymph node metastasis (<2 cm grade 1 tumors with superficial myometrial invasion), however, a systematic lymph node dissection should be performed in most other patients with endometrial cancer. In the future, molecular markers may be useful to predict preoperatively tumor aggressiveness and lymph node metastasis. It is hoped that an approach of surgical staging with selective lymph node dissection will improve survival and spare patients additional surgical complications or unnecessary postoperative exposure to radiation and/or chemotherapy.

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The risk factors for lymph node metastasis in early gastric cancer patients who underwent endoscopic resection: is the minimal lymph node dissection applicable?

Surgical Endoscopy ◽

10.1007/s00464-013-2901-z ◽

2013 ◽

Vol 27 (9) ◽

pp. 3247-3253 ◽

Cited By ~ 37

Author(s):

Sang Yong Son ◽

Ji Yeon Park ◽

Keun Won Ryu ◽

Bang Wool Eom ◽

Hong Man Yoon ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Early Gastric Cancer ◽

Cancer Patients ◽

Lymph Node Dissection ◽

Node Dissection ◽

Node Metastasis ◽

Gastric Cancer Patients

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Long Non-coding RNA SPRY4-IT1 as a Promising Indicator for Three Field Lymph-node Dissection of Thoracic Esophageal Carcinoma

10.21203/rs.3.rs-94762/v1 ◽

2020 ◽

Author(s):

Peng Qie ◽

Qifan Yin ◽

Xuejiao Xun ◽

Yongbin Song ◽

Shaohui Zhou ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Node Dissection ◽

Mediastinal Lymph Node ◽

High Expression ◽

Expression Level ◽

Node Dissection ◽

Node Metastasis ◽

T Classification

Abstract Backgroup：Esophageal squamous cell carcinoma(ESCC) is one of the most common tumors worldwide. Esophagectomy with three-field lymph node dissection(3FLND) is the radical surgical procedure for esophageal cancer. However, 3FLND is not widely used due to it’s higher mortality rate and higher incidence of postoperative complications. There is an urgent need to identify novel biomarkers that can guide the most proper lymph-node dissection in esophageal cancer patients.Method：Ninety-two patients with thoracic ESCC undergoing 3FLND were enrolled into our study from the Department of Thoracic Surgery of the Fourth Hospital affiliated to the Hebei Medical University and Hebei General Hospital between Jun 2011 and Dec 2015. Retrospectively collected data from these 92 patients was used to explore the relationship between the lymph-node metastasis、recurrence and the SPRY4-IT1 expression level and to determine whether 3FLND should be performed in patients with thoracic ESCC. Results: The findings revealed that the SPRY4-IT1 expression was significantly higher in esophageal cancer tissues than in adjacent noncancerous tissues. (P<0.01). Furthermore, the high expression of SPRY4-IT1 was significantly correlated with tumor differentiation (P=0.029), T classification (P=0.013), lymph node metastasis(P=0.022) and pathological stage (P=0.001). The increased expression of SPRY4-IT1 was associated with a higher risk of cervical and superior mediastinal lymph-node metastasis(P = 0.039).However, no significant association was observed between the risk of cervical and superior mediastinal lymph-node recurrence and the SPRY4-IT1 expression level in the thoracic ESCC patients performed 3FLND(P=0.509). Conclusions: Our data support the assumption that the high expression of SPRY4-IT1 is associated with a high risk of lymph node metastasis and it has potential application as a indicator for guiding on three-field lymph node dissection in patients with thoracic ESCC. Randomized controlled trials with a large cohort of patients will be needed to confirm this conclusion in the future.

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