Independent risk factors for lymph node metastasis in 2623 patients with Non–Small cell lung cancer

Xue, Xinying; Zang, Xuelei; Liu, Yuxia; Lin, Dongliang; Jiang, Tianyun; Gao, Jie; Wu, Chongchong; Ma, Xidong; Deng, Hui; Yu, Zhaofeng; Pan, Lei; Xue, Zhiqiang

doi:10.1016/j.suronc.2020.05.005

Cited by 12 publications

(9 citation statements)

References 22 publications

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“…12 Similarly, the conclusion of Xue X et al mentioned that gender is not related to lymph node metastasis. 13 The ndings of this study reveal that age wasn't a risk factor for lymph node metastasis in NCSLC, whereas age is, according to some scholars' analysis, one of the risk factors for lymph node metastasis. 13 Additionally, the visceral pleural invasion wasn't related to lymph node metastasis in this study.…”

Section: Risk Factors For Lymph Node Metastasismentioning

confidence: 70%

“…13 The ndings of this study reveal that age wasn't a risk factor for lymph node metastasis in NCSLC, whereas age is, according to some scholars' analysis, one of the risk factors for lymph node metastasis. 13 Additionally, the visceral pleural invasion wasn't related to lymph node metastasis in this study. Some other studies, however, have shown that visceral pleural invasion could be a risk factor for lymph node metastasis.…”

Section: Risk Factors For Lymph Node Metastasismentioning

confidence: 70%

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Risk factors for lymph node metastasis and poor prognosis in pathological stage I and II non-small cell lung cancer

Zhang

Wang

2022

Preprint

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Objective To study the influencing factors of lymph node metastasis and survival in pathological stage Ⅰ and Ⅱ non-small cell lung cancer. Methods Clinical data of 381 patients were collected and followed up. The primary outcome measure was overall survival and 5-year survival rate. Results Binary logistic regression results showed that tumor size (OR = 1.422; 95%CI: 1.174 ~ 1.723), increased preoperative CEA (OR = 1.056; 95%CI: 1.012 ~ 1.101) and gender (OR = 0.476; 95%CI: 0.243 ~ 0.934) were the factors affecting lymph node metastasis in pathological stage Ⅰ and Ⅱ non-small cell lung cancer (all P-value < 0.05). Results from multivariate Cox proportional hazards model showed that age (hazard ratio = 2.716 for age > 60 years; p = 0.001), larger tumor size (hazard ratio = 1.400 for tumor size ≥ 2.25cm; p = 0.004) and visceral pleural invasion (hazard ratio = 2.919 for visceral pleural invasion; p < 0.001) were the predictors of poor prognosis (all P-value < 0.05). Conclusion In pathological stage I and II non-small cell lung cancer, being males, tumor size ≥ 2.25cm and the preoperative CEA ≥ 3.47ug/L were risk factors for lymph node metastasis. Age > 60 years, visceral pleural invasion, and larger tumor are predictors of postoperative poor prognosis.

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Section: Risk Factors For Lymph Node Metastasismentioning

confidence: 70%

Section: Risk Factors For Lymph Node Metastasismentioning

confidence: 70%

Risk factors for lymph node metastasis and poor prognosis in pathological stage I and II non-small cell lung cancer

Zhang

Wang

2022

Preprint

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“…Therefore, lymph node dissection or sampling is not required for AIS and MIA, while SMLD is recommended for invasive adenocarcinoma, especially MPA. Xue et al [25] reported lymph node metastasis rates of 11.9% (28/235), 23.5% (215/915), 36.4%(536/1473) at Ki-67 of 5%, 5%-25% and ≥25%, respectively, and the differences were statistically signi cant (P 0.001). Similarly, in this study, the Ki-67 index was a pN risk factor with a cut-off value of 12.5%.…”

Section: Discussionmentioning

confidence: 95%

Clinical Value of CTR, CEA, Histological Type, Ki-67 and EGFR in Predicting pN in Clinical Stage IA Lung Adenocarcinoma and Nomogram Construction

Qin

et al. 2021

Preprint

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To investigate the clinical value of CTR, CEA, histological type, Ki-67 and EGFR in detecting pathological lymph node metastasis (pN) in clinical stage IA (cIA) lung adenocarcinoma and to construct a pN Nomogram model. A total of 374 cIA lung adenocarcinoma patients who had undergone thoracoscopic radical resection with Systematic mediastinal lymph node dissection (SMLD) in the Department of Thoracic Surgery of the Affiliated Hospital of Qingdao University between January 2018 to January 2020 were retrospectively reviewed. The patients were divided into pN(+) and pN(-) groups. Univariate and multivariate Logistic regression analyses were used to analyze the independent risk factors of pN in lung cancer patients. The ROC curve was used to compare the accuracy of CTR, CEA and Ki-67 in predicting pN. R software was used to construct a Nomogram prediction model based on multivariate Logistic regression analysis of the pN risk. The C-index was calculated, and a calibration curve was drawn to judge the calibration degree of the model. The preoperative and intraoperative examinations showed that CTR (OR 570.406, P＜0.001), CEA (OR 1.239, P＜0.001) and micropapillary adenocarcinoma (OR 86.712, P＜0.001) were independent risk factors of pN. Immunohistochemical analysis and gene detection showed that Ki-67 index (OR 4.832, P＜0.001) and EGFR mutations, such as exon 19 (OR 10.319, P＜0.001), exon 21 (OR 7.163, P＜0.001) and exon 19+20 mutations (OR 570.406, P＜0.001), were significant factors in predicting pN. CTR, CEA, histological type, Ki-67 index, and EGFR mutations are the predictive factors of pN in cT1a-3aN0M0 lung adenocarcinoma patients. SMLD is recommended to improve patients’ postoperative survival rate when preoperative CTR≥0.775, CEA＞2.52μg/L or intraoperative rapid freezing pathology shows micropapillary components.

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“…In particular, in the absence of lymph node metastasis, tumor size is not a significant prognostic sign. However, the histological type of NSCLC is prognostically important; poor prognosis is associated with squamous cell lung cancer and undifferentiated cancer [32]. The statistically significant factors of unfavorable prognosis are LDH activity less than 1294 U/L and a DC level of more than 3.97 c.u.…”

Section: Discussionmentioning

confidence: 99%

Survival Rates of Patients with Non-Small Cell Lung Cancer Depending on Lymph Node Metastasis: A Focus on Saliva

2021

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The aim of this study was to compare overall survival (OS) rates at different pN stages of NSCLC depending on tumor characteristics and to assess the applicability of saliva biochemical markers as prognostic signs. The study included 239 patients with NSCLC (pN0-120, pN1-51, pN2-68). Saliva was analyzed for 34 biochemical indicators before the start of treatment. For pN0, the tumor size does not have a prognostic effect, but the histological type should be taken into account. For pN1 and pN2, long-term results are significantly worse in squamous cell cancer with a large tumor size. A larger volume of surgical treatment reduces the differences between OS. The statistically significant factors of an unfavorable prognosis at pN0 are the lactate dehydrogenase activity <1294 U/L and the level of diene conjugates >3.97 c.u. (HR = 3.48, 95% CI 1.21–9.85, p = 0.01541); at pN1, the content of imidazole compounds >0.296 mmol/L (HR = 6.75, 95% CI 1.28–34.57, p = 0.00822); at pN2 levels of protein <0.583 g/L and Schiff bases >0.602 c.u., as well as protein >0.583 g/L and Schiff bases <0.602 c.u. (HR = 2.07, 95% CI 1.47–8.93, p = 0.04351). Using salivary biochemical indicators, it is possible to carry out stratification into prognostic groups depending on the lymph node metastasis.

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Independent risk factors for lymph node metastasis in 2623 patients with Non–Small cell lung cancer

Cited by 12 publications

References 22 publications

Risk factors for lymph node metastasis and poor prognosis in pathological stage I and II non-small cell lung cancer

Risk factors for lymph node metastasis and poor prognosis in pathological stage I and II non-small cell lung cancer

Clinical Value of CTR, CEA, Histological Type, Ki-67 and EGFR in Predicting pN in Clinical Stage IA Lung Adenocarcinoma and Nomogram Construction

Survival Rates of Patients with Non-Small Cell Lung Cancer Depending on Lymph Node Metastasis: A Focus on Saliva

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