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Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer

BACKGROUND: The nodal classification of lung cancer is determined by the anatomical location of metastatic lymph nodes (mLNs). However, prognosis can be heterogeneous at the same nodal stage, and the current classification system requires improvement. Therefore, we investigated the correlation betwe...

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Autores principales: Samejima, Joji, Ito, Hiroyuki, Nagashima, Takuya, Nemoto, Daiji, Eriguchi, Daisuke, Nakayama, Haruhiko, Ikeda, Norihiko, Okada, Morihito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8339744/
https://www.ncbi.nlm.nih.gov/pubmed/34422338
http://dx.doi.org/10.21037/jtd-21-390
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author Samejima, Joji
Ito, Hiroyuki
Nagashima, Takuya
Nemoto, Daiji
Eriguchi, Daisuke
Nakayama, Haruhiko
Ikeda, Norihiko
Okada, Morihito
author_facet Samejima, Joji
Ito, Hiroyuki
Nagashima, Takuya
Nemoto, Daiji
Eriguchi, Daisuke
Nakayama, Haruhiko
Ikeda, Norihiko
Okada, Morihito
author_sort Samejima, Joji
collection PubMed
description BACKGROUND: The nodal classification of lung cancer is determined by the anatomical location of metastatic lymph nodes (mLNs). However, prognosis can be heterogeneous at the same nodal stage, and the current classification system requires improvement. Therefore, we investigated the correlation between the number of mLNs and prognosis in patients with non-small cell lung cancer. METHODS: Using a multicenter database in Japan, we retrospectively reviewed the records of patients who underwent complete resection for lung cancer between 2010 and 2016. Kaplan-Meier curves were used to determine recurrence-free and overall survival. Multivariate analyses were performed using the Cox proportional hazards model. RESULTS: We included 1,567 patients in this study. We could show a statistically significant difference in recurrence-free survival between pN2 patients with 1 mLN and pN2 patients with ≥2 mLNs (P=0.016). Patients with a combination of pN1 (≥4 mLNs) plus pN2 (1 mLN) had a poorer prognosis than pN1 patients (1-3 mLNs) (P=0.061) and a better prognosis than pN2 patients (≥2 mLNs) patients (P=0.007). Multivariate analysis showed that the number of mLNs was independently associated with cancer recurrence in patients with pN1 and pN2 disease (P=0.034 and 0.018, respectively). CONCLUSIONS: Nodal classification that combines anatomical location and the number of mLNs may predict prognosis more accurately than the current classification system. Our study provides the concept that supports the subdivision of nodal classification in the upcoming revision of the tumor, node, and metastasis staging system.
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spelling pubmed-83397442021-08-20 Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer Samejima, Joji Ito, Hiroyuki Nagashima, Takuya Nemoto, Daiji Eriguchi, Daisuke Nakayama, Haruhiko Ikeda, Norihiko Okada, Morihito J Thorac Dis Original Article BACKGROUND: The nodal classification of lung cancer is determined by the anatomical location of metastatic lymph nodes (mLNs). However, prognosis can be heterogeneous at the same nodal stage, and the current classification system requires improvement. Therefore, we investigated the correlation between the number of mLNs and prognosis in patients with non-small cell lung cancer. METHODS: Using a multicenter database in Japan, we retrospectively reviewed the records of patients who underwent complete resection for lung cancer between 2010 and 2016. Kaplan-Meier curves were used to determine recurrence-free and overall survival. Multivariate analyses were performed using the Cox proportional hazards model. RESULTS: We included 1,567 patients in this study. We could show a statistically significant difference in recurrence-free survival between pN2 patients with 1 mLN and pN2 patients with ≥2 mLNs (P=0.016). Patients with a combination of pN1 (≥4 mLNs) plus pN2 (1 mLN) had a poorer prognosis than pN1 patients (1-3 mLNs) (P=0.061) and a better prognosis than pN2 patients (≥2 mLNs) patients (P=0.007). Multivariate analysis showed that the number of mLNs was independently associated with cancer recurrence in patients with pN1 and pN2 disease (P=0.034 and 0.018, respectively). CONCLUSIONS: Nodal classification that combines anatomical location and the number of mLNs may predict prognosis more accurately than the current classification system. Our study provides the concept that supports the subdivision of nodal classification in the upcoming revision of the tumor, node, and metastasis staging system. AME Publishing Company 2021-07 /pmc/articles/PMC8339744/ /pubmed/34422338 http://dx.doi.org/10.21037/jtd-21-390 Text en 2021 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
Samejima, Joji
Ito, Hiroyuki
Nagashima, Takuya
Nemoto, Daiji
Eriguchi, Daisuke
Nakayama, Haruhiko
Ikeda, Norihiko
Okada, Morihito
Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer
title Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer
title_full Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer
title_fullStr Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer
title_full_unstemmed Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer
title_short Anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer
title_sort anatomical location and number of metastatic lymph nodes for prognosis of non-small cell lung cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8339744/
https://www.ncbi.nlm.nih.gov/pubmed/34422338
http://dx.doi.org/10.21037/jtd-21-390
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