scholarly journals Risk Factors for Lymph Node Metastasis and Surgical Scope in Patients With Early-Stage Non-Small Cell Lung Cancer: A Single-Center Study in China

2021 ◽  
Author(s):  
Jianlong Bu ◽  
Pinyi Zhang ◽  
Xiaohong Wu ◽  
Su Zhao ◽  
Sainan Pang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Stage ◽  
Node Metastasis ◽  
Early Stage Nsclc ◽  
Preoperative Serum ◽  
Serum Cea ◽  
Independent Risk Factors ◽  
Tumor Parenchyma

Abstract Background It is difficult to determine the lymph node metastasis of patients with early-stage non-small cell lung cancer (NSCLC) before surgery. The purpose of this study is to investigate risk factors of lymph node metastasis in early-stage NSCLC, thereby to identify the surgical indications for lymph node dissection in early-stage NSCLC. Methods We conducted a retrospective study of patients with tumor size ≤ 30mm who underwent radical resection of NSCLC. Binary logistic regression analysis was applied to predict risk factors for lymph node metastasis, and subject operating characteristics (ROC) curve was used to evaluate the independent risk factors. Results Overall, 44 patients (6.8%) with early-stage NSCLC had lymph node metastasis. Factors of tumor consolidation diameter (p < 0.001) and preoperative serum carcinoembryonic antigen (CEA) level (p = 0.017) are independent risk factors lymph node metastasis in early-stage NSCLC. The ROC curve showed that the cut-off value of consolidation diameter was 16.5mm, and the area under the curve (AUC) was 0.825 (p < 0.001, 95% CI: 0.780–0.870); the cut-off value of serum CEA level was 1.765µg/L, AUC = 0.661( p < 0.001, 95% CI: 0.568–0.754). Moreover, 8 of 461 patients with tumor parenchyma ≤ 16.5mm had lymph node metastasis, and 36 of 189 patients with tumor parenchyma > 16.5mm had lymph node metastasis. Conclusion Tumor consolidation diameter and preoperative serum CEA are independent factors to predict early stage NSCLC. For patients with tumor parenchyma > 16.5mm, the probability of lymph node metastasis is higher and lobectomy plus lymph node dissection is recommended. For patients with tumor parenchyma ≤ 16.5mm, the probability of lymph node metastasis is lower and sublobectomy plus lymph node sampling is feasible.

scholarly journals Risk factors for lymph node metastasis and surgical scope in patients with cN0 non-small cell lung cancer: a single-center study in China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Bu Jianlong ◽  
Zhang Pinyi ◽  
Wu Xiaohong ◽  
Zhao Su ◽  
Pang Sainan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastasis ◽  
Preoperative Serum ◽  
Serum Cea ◽  
Independent Risk Factors ◽  
Tumor Parenchyma

Abstract Background It is difficult to determine the lymph node metastasis of patients with clinically negative lymph nodes (cN0) non-small cell lung cancer (NSCLC) before surgery. The purpose of this study is to investigate risk factors of lymph node metastasis in cN0 NSCLC, thereby to identify the surgical indications for lymph node dissection in cN0 NSCLC. Methods We conducted a retrospective study of patients with tumor size ≤ 30 mm who underwent radical resection of NSCLC. Binary logistic regression analysis was applied to predict risk factors for lymph node metastasis, and subject operating characteristics (ROC) curve was used to evaluate the independent risk factors. Results Overall, 44 patients (6.8%) with cN0 NSCLC had lymph node metastasis. Factors of tumor consolidation diameter (p < 0.001) and preoperative serum carcinoembryonic antigen (CEA) level (p = 0.017) are independent risk factors lymph node metastasis in cN0 NSCLC. The ROC curve showed that the cut-off value of consolidation diameter was 16.5 mm, and the area under the curve (AUC) was 0.825 (p < 0.001, 95% CI 0.780–0.870); the cut-off value of serum CEA level was 1.765 μg/L, and the AUC was 0.661 (p < 0.001, 95% CI: 0.568–0.754). Moreover, 8 of 461 patients with tumor parenchyma ≤ 16.5 mm had lymph node metastasis, and 36 of 189 patients with tumor parenchyma > 16.5 mm had lymph node metastasis. Conclusion Tumor consolidation diameter and preoperative serum CEA are independent factors to predict cN0 NSCLC with tumor size ≤ 30 mm. For patients with tumor parenchyma > 16.5 mm, the probability of lymph node metastasis is higher and lymph node dissection is recommended. For patients with tumor parenchyma ≤ 16.5 mm, the probability of lymph node metastasis is lower and lymph node sampling is feasible.

scholarly journals A nomogram to predict lymph node metastasis risk for early esophageal squamous cell carcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofeng Duan ◽  
Xiaobin Shang ◽  
Jie Yue ◽  
Zhao Ma ◽  
Chuangui Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Derivation Cohort ◽  
Node Metastasis

Abstract Background A nomogram was developed to predict lymph node metastasis (LNM) for patients with early-stage esophageal squamous cell carcinoma (ESCC). Methods We used the clinical data of ESCC patients with pathological T1 stage disease who underwent surgery from January 2011 to June 2018 to develop a nomogram model. Multivariable logistic regression was used to confirm the risk factors for variable selection. The risk of LNM was stratified based on the nomogram model. The nomogram was validated by an independent cohort which included early ESCC patients underwent esophagectomy between July 2018 and December 2019. Results Of the 223 patients, 36 (16.1%) patients had LNM. The following three variables were confirmed as LNM risk factors and were included in the nomogram model: tumor differentiation (odds ratio [OR] = 3.776, 95% confidence interval [CI] 1.515–9.360, p = 0.004), depth of tumor invasion (OR = 3.124, 95% CI 1.146–8.511, p = 0.026), and tumor size (OR = 2.420, 95% CI 1.070–5.473, p = 0.034). The C-index was 0.810 (95% CI 0.742–0.895) in the derivation cohort (223 patients) and 0.830 (95% CI 0.763–0.902) in the validation cohort (80 patients). Conclusions A validated nomogram can predict the risk of LNM via risk stratification. It could be used to assist in the decision-making process to determine which patients should undergo esophagectomy and for which patients with a low risk of LNM, curative endoscopic resection would be sufficient.

Comparative study of preoperative prediction scores for lymph node metastasis in gastric and colon cancer patients

2020 ◽  
Author(s):  
Xiangjian Zheng ◽  
Xiaodong Chen ◽  
Min Li ◽  
Chunmeng Li ◽  
Xian Shen
Keyword(s):  
Risk Factors ◽  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Serum Markers ◽  
Tumor Characteristics ◽  
Node Metastasis ◽  
Preoperative Prediction ◽  
Independent Risk Factors

Abstract Background: Surgery combined with chemo-radiotherapy is a recognized model for the treatment of gastric and colon cancers. Lymph node metastasis determines the patient's surgical or comprehensive treatment plan. This analytical study aims to compare preoperative prediction scores to better predict lymph node metastasis in gastric and colon cancer patients.Methods: This study comprised 768 patients, which included 312 patients with gastric cancer and 462 with colon cancer. Preoperative clinical tumor characteristics, serum markers, and immune indices were evaluated using single-factor analysis. Logistic analysis was designed to recognize independent predictors of lymph node metastasis in these patients. The independent risk factors were integrated into preoperative prediction scores, which were accurately assessed using receiver operating characteristic (ROC) curves.Results: Results showed that serum markers (CA125, hemoglobin, albumin), immune indices (S100, CD31, d2–40), and tumor characteristics (pathological type, size) were independent risk factors for lymph node metastasis in patients with gastric and colon cancer. The preoperative prediction scores reliably predicted lymph node metastasis in gastric and colon cancer patients with a higher area under the ROC curve (0.901). The area was 0.923 and 0.870 in gastric cancer and colon cancer, respectively. Based on the ROC curve, the ideal cutoff value of preoperative prediction scores to predict lymph node metastasis was established to be 287. Conclusion: The preoperative prediction scores is a useful indicator that can be applied to predict lymph node metastasis in gastric and colon cancer patients.

Uterine corpus invasion as a risk factor in patients with early-stage cervical carcinoma receiving radical surgery.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17012-e17012
Author(s):  
Yifan Li ◽  
Ning Li ◽  
Lingying Wu
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Carcinoma ◽  
Radical Surgery ◽  
Early Stage ◽  
Univariate Analysis ◽  
Uterine Corpus ◽  
Node Metastasis

e17012 Background: To explore whether pathologically verified uterine corpus invasion (UCI) is a risk factor for patients with early-stage (IB1-IIA2) cervical carcinoma receiving radical surgery. Methods: A mathed-case comparison of early-stage cervical carcinoma patients with pathologically verified UCI to patients without UCI on a 1:1 ratio was conducted. High risk factors (lymph node metastasis, paremetrial invasion, vaginal margin invasion) and intermediate risk factors (lymphovascular space invasion (LVSI) and deep stromal invasion) were completely matched between UCI and non-UCI groups. Kaplan-Meier and Log-rank test were applied for univariate analysis, and COX proportional hazard regression models were used for multivariate analysis. Results: 1320 consecutive patients with cervical carcinoma received surgery in our centerfrom Jan. 1st2009 to Dec 31st2014. 79 (5.98%) cases with UCI were identified. Median follow-up time was 43 months. There were 22 cases with recurrence. In UCI group, the recurrence rate was 20.3% (16/79), and in non-UCI group the recurrence rate was 7.6% (6/79). On univariate analysis, SCC, neoadjuvant chemotherapy (NACT), lymph node metastasis, parametrial invasion, LVSI, deep stromal invasion, vaginal invasion and UCI were significantly associated with disease free survival (DFS). After multivariate analysis, UCI ( p= 0.02, RR3.832, 95% CI1.235-11.893)and lymph node metastasis ( p= 0.042, RR 2.890, 95% CI1.038-8.045) were still independent risk factors for deceased DFS. Conclusions: Pathologically verified uterine corpus invasion might be an independent risk factor for decreased DFS in patients with early-stage cervical carcinoma receiving radical surgery.

scholarly journals Nomograms for Predicting the Lymph Node Metastasis in Early Gastric Cancer by Gender: A Retrospective Multicentric Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Wannian Sui ◽  
Zhangming Chen ◽  
Chuanhong Li ◽  
Peifeng Chen ◽  
Kai Song ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Depth Of Invasion ◽  
Male And Female ◽  
Node Metastasis ◽  
Independent Risk Factors ◽  
Medical University ◽  
Training Sets

BackgroundLymph node metastasis (LNM) has a significant impact on the prognosis of patients with early gastric cancer (EGC). Our aim was to identify the independent risk factors for LNM and construct nomograms for male and female EGC patients, respectively.MethodsClinicopathological data of 1,742 EGC patients who underwent radical gastrectomy and lymphadenectomy in the First Affiliated Hospital, Second Affiliated Hospital, and Fourth Affiliated Hospital of Anhui Medical University between November 2011 and April 2021 were collected and analyzed retrospectively. Male and female patients from the First Affiliated Hospital of Anhui Medical University were assigned to training sets and then from the Second and Fourth Affiliated Hospitals of Anhui Medical University were enrolled in validation sets. Based on independent risk factors for LNM in male and female EGC patients from the training sets, the nomograms were established respectively, which was also verified by internal validation from the training sets and external validation from the validation sets.ResultsTumor size (odd ratio (OR): 1.386, p = 0.030), depth of invasion (OR: 0.306, p = 0.001), Lauren type (OR: 2.816, p = 0.000), lymphovascular invasion (LVI) (OR: 0.160, p = 0.000), and menopause (OR: 0.296, p = 0.009) were independent risk factors for female EGC patients. For male EGC patients, tumor size (OR: 1.298, p = 0.007), depth of invasion (OR: 0.257, p = 0.000), tumor location (OR: 0.659, p = 0.002), WHO type (OR: 1.419, p = 0.001), Lauren type (OR: 3.099, p = 0.000), and LVI (OR: 0.131, p = 0.000) were independent risk factors. Moreover, nomograms were established to predict the risk of LNM for female and male EGC patients, respectively. The area under the ROC curve of nomograms for female and male training sets were 87.7% (95% confidence interval (CI): 0.8397–0.914) and 94.8% (95% CI: 0.9273–0.9695), respectively. For the validation set, they were 92.4% (95% CI: 0.7979–1) and 93.4% (95% CI: 0.8928–0.9755), respectively. Additionally, the calibration curves showed good agreements between the bias-corrected prediction and the ideal reference line for both training sets and validation sets in female and male EGC patients.ConclusionsNomograms based on risk factors for LNM in male and female EGC patients may provide new insights into the selection of appropriate treatment methods.

scholarly journals Comparative Study of Preoperative Scores to Predict Lymph Node Metastasis in Patients With Gastric and Colon Cancers: A Case Control Study

2020 ◽  
Author(s):  
Xiangjian Zheng ◽  
Xiaodong Chen ◽  
Min Li ◽  
Chunmeng Li ◽  
Xian Shen
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Roc Curve ◽  
Serum Markers ◽  
Tumor Characteristics ◽  
Immune Markers ◽  
Node Metastasis ◽  
Colon Cancers ◽  
Independent Risk Factors

Abstract Background:Surgery combined with chemo-radiotherapy is a recognized model for the treatment of gastric and colon cancers. Lymph node metastasis determines the patient's surgical or comprehensive treatment plan.The purpose of this study was to compare preoperative scores to better predict lymph node metastasis in patients with gastric and colon cancers.Methods:A total of 768 patients with gastric cancer (312) and colon cancer (462) were enrolled in our study. Preoperative serum markers, immune markers, and clinical tumor characteristics were evaluated by single-factor analysis. Logistic analysis was used to identify independent predictors of lymph node metastasis in patients with gastric and colon cancers. These independent risk factors were integrated into preoperative scores, which was evaluated by receiver operating characteristic (ROC) curves.Results:The result showed that serum markers (CA125, hemoglobin, albumin), immune markers (S100, CD31, d2–40), and tumor characteristics (pathological type, tumor size) were independent risk factors for lymph node metastasis in patients with gastric and colon cancers. The preoperative scores reliably predicted lymph node metastasis in patients with gastric and colon cancers with a higher area under the ROC curve (0.901). Compared to the other independent risk factors, the area under the ROC curve of this indicator was 0.923 and 0.870, for gastric and colon cancers, respectively. Based on the ROC curve, the ideal cutoff value of preoperative scores to predict lymph node metastasis was established to be 287. Conclusion: The preoperative scores is a useful indicator that could be used to predict lymph node metastasis in patients with gastric and colon cancers.

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