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Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study

BACKGROUND: In the TNM system only the anatomic location is used to define nodal status. In this study we aim to evaluate the effectiveness of combining the location and ratio of metastatic lymph node (pN-NR) for the prognosis of non-small cell lung cancer (NSCLC). METHODS: Patients with pN1/pN2 NSC...

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Autores principales: Xing, Huajie, Hu, Mengyu, Chen, Jingyu, Guo, Yongqing, Liu, Deruo, Liang, Chaoyang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399421/
https://www.ncbi.nlm.nih.gov/pubmed/32802434
http://dx.doi.org/10.21037/jtd-20-758
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author Xing, Huajie
Hu, Mengyu
Chen, Jingyu
Guo, Yongqing
Liu, Deruo
Liang, Chaoyang
author_facet Xing, Huajie
Hu, Mengyu
Chen, Jingyu
Guo, Yongqing
Liu, Deruo
Liang, Chaoyang
author_sort Xing, Huajie
collection PubMed
description BACKGROUND: In the TNM system only the anatomic location is used to define nodal status. In this study we aim to evaluate the effectiveness of combining the location and ratio of metastatic lymph node (pN-NR) for the prognosis of non-small cell lung cancer (NSCLC). METHODS: Patients with pN1/pN2 NSCLC were retrieved from the SEER database. The optimal cut point of NR was determined with the maximal selecting test. All patients were divided into 4 categories with combination of pN (pN1 or pN2) and NR (low or high). The pN-NR was investigated as a predictor of overall survival (OS) and cause-specific survival (CSS) using Cox regression models. Survival curves were plotted using the Kaplan-Meier method and the difference was compared with log-rank test. RESULTS: A total of 12,170 patients were enrolled. The optimal cut point of NR was 0.3. Patients were divided into 4 groups: pN1-NR <0.3, pN1-NR ≥0.3, pN2-NR <0.3 and pN2-NR ≥0.3. The pN-NR was an independent prognostic factor for survival. Compared with pN1-NR <0.3, the hazard ratio of OS was 1.405 (95% CI: 1.295–1.524), 1.183 (95% CI: 1.113–1257) and 1.717 (95% CI: 1.607–1.835) times higher for pN1-NR ≥0.3, pN2-NR <0.3 and pN2-NR ≥0.3 group, respectively. The survival curves of OS separated well between the 4 pN-NR groups, with 5-year OS 47.1% for pN1-NR <0.3, 43.0% for pN2-NR <0.3, 35.0% for pN1-NR ≥0.3 and 28.5% for pN2-NR ≥0.3, and the P value between neighboring curves was statistically significantly. The same trend was observed for CSS. Subgroup analysis revealed similar results except the pneumonectomy group. CONCLUSIONS: pN-NR could be a good predictor for the prognosis of NSCLC.
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spelling pubmed-73994212020-08-13 Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study Xing, Huajie Hu, Mengyu Chen, Jingyu Guo, Yongqing Liu, Deruo Liang, Chaoyang J Thorac Dis Original Article BACKGROUND: In the TNM system only the anatomic location is used to define nodal status. In this study we aim to evaluate the effectiveness of combining the location and ratio of metastatic lymph node (pN-NR) for the prognosis of non-small cell lung cancer (NSCLC). METHODS: Patients with pN1/pN2 NSCLC were retrieved from the SEER database. The optimal cut point of NR was determined with the maximal selecting test. All patients were divided into 4 categories with combination of pN (pN1 or pN2) and NR (low or high). The pN-NR was investigated as a predictor of overall survival (OS) and cause-specific survival (CSS) using Cox regression models. Survival curves were plotted using the Kaplan-Meier method and the difference was compared with log-rank test. RESULTS: A total of 12,170 patients were enrolled. The optimal cut point of NR was 0.3. Patients were divided into 4 groups: pN1-NR <0.3, pN1-NR ≥0.3, pN2-NR <0.3 and pN2-NR ≥0.3. The pN-NR was an independent prognostic factor for survival. Compared with pN1-NR <0.3, the hazard ratio of OS was 1.405 (95% CI: 1.295–1.524), 1.183 (95% CI: 1.113–1257) and 1.717 (95% CI: 1.607–1.835) times higher for pN1-NR ≥0.3, pN2-NR <0.3 and pN2-NR ≥0.3 group, respectively. The survival curves of OS separated well between the 4 pN-NR groups, with 5-year OS 47.1% for pN1-NR <0.3, 43.0% for pN2-NR <0.3, 35.0% for pN1-NR ≥0.3 and 28.5% for pN2-NR ≥0.3, and the P value between neighboring curves was statistically significantly. The same trend was observed for CSS. Subgroup analysis revealed similar results except the pneumonectomy group. CONCLUSIONS: pN-NR could be a good predictor for the prognosis of NSCLC. AME Publishing Company 2020-07 /pmc/articles/PMC7399421/ /pubmed/32802434 http://dx.doi.org/10.21037/jtd-20-758 Text en 2020 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Xing, Huajie
Hu, Mengyu
Chen, Jingyu
Guo, Yongqing
Liu, Deruo
Liang, Chaoyang
Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study
title Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study
title_full Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study
title_fullStr Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study
title_full_unstemmed Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study
title_short Combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study
title_sort combining node location and node ratio as a prognostic factor for surgical resected non-small cell lung cancer: a population-based study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399421/
https://www.ncbi.nlm.nih.gov/pubmed/32802434
http://dx.doi.org/10.21037/jtd-20-758
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