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Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter

BACKGROUND: Lung adenocarcinoma is the most common subtype of non-small cell lung cancer. The surgical strategy of lymph node dissection is controversial because many more patients are diagnosed at an early stage in clinical practice. METHODS: We retrospectively reviewed 622 clinical N0 lung adenoca...

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Autores principales: Fang, Cheng, Xiang, Yangwei, Han, Weili
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052540/
https://www.ncbi.nlm.nih.gov/pubmed/35488235
http://dx.doi.org/10.1186/s12893-022-01605-z
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author Fang, Cheng
Xiang, Yangwei
Han, Weili
author_facet Fang, Cheng
Xiang, Yangwei
Han, Weili
author_sort Fang, Cheng
collection PubMed
description BACKGROUND: Lung adenocarcinoma is the most common subtype of non-small cell lung cancer. The surgical strategy of lymph node dissection is controversial because many more patients are diagnosed at an early stage in clinical practice. METHODS: We retrospectively reviewed 622 clinical N0 lung adenocarcinoma patients with 3 cm or less in tumor size who underwent lobectomy or segmentectomy combined with lymph node dissection in our hospital from January 2017 to December 2019. We performed univariate and multivariate analyses to identify preoperative risk factors of lymph node metastasis. RESULTS: Lymph node metastasis was found in 60 out of 622 patients. On univariate analysis, lymph node metastasis was linked to smoking history, preoperative CEA level, tumor size, tumor location (peripheral or central), consolidation/tumor ratio, pleural invasion, and pathologic type. However, only the preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors in multivariate analysis. The ROC curve showed that the cutoff value of tumor size was 1.7 cm. There was no lymph node metastasis in patients without risk factors. CONCLUSIONS: The preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma with tumor size ≤ 3 cm. The lymph node metastasis rate was extremely low in clinical N0 lung adenocarcinoma patients without risk factors and lymph node dissection should be avoided in these patients to reduce surgical trauma.
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spelling pubmed-90525402022-04-30 Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter Fang, Cheng Xiang, Yangwei Han, Weili BMC Surg Research BACKGROUND: Lung adenocarcinoma is the most common subtype of non-small cell lung cancer. The surgical strategy of lymph node dissection is controversial because many more patients are diagnosed at an early stage in clinical practice. METHODS: We retrospectively reviewed 622 clinical N0 lung adenocarcinoma patients with 3 cm or less in tumor size who underwent lobectomy or segmentectomy combined with lymph node dissection in our hospital from January 2017 to December 2019. We performed univariate and multivariate analyses to identify preoperative risk factors of lymph node metastasis. RESULTS: Lymph node metastasis was found in 60 out of 622 patients. On univariate analysis, lymph node metastasis was linked to smoking history, preoperative CEA level, tumor size, tumor location (peripheral or central), consolidation/tumor ratio, pleural invasion, and pathologic type. However, only the preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors in multivariate analysis. The ROC curve showed that the cutoff value of tumor size was 1.7 cm. There was no lymph node metastasis in patients without risk factors. CONCLUSIONS: The preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma with tumor size ≤ 3 cm. The lymph node metastasis rate was extremely low in clinical N0 lung adenocarcinoma patients without risk factors and lymph node dissection should be avoided in these patients to reduce surgical trauma. BioMed Central 2022-04-29 /pmc/articles/PMC9052540/ /pubmed/35488235 http://dx.doi.org/10.1186/s12893-022-01605-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Fang, Cheng
Xiang, Yangwei
Han, Weili
Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter
title Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter
title_full Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter
title_fullStr Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter
title_full_unstemmed Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter
title_short Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter
title_sort preoperative risk factors of lymph node metastasis in clinical n0 lung adenocarcinoma of 3 cm or less in diameter
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052540/
https://www.ncbi.nlm.nih.gov/pubmed/35488235
http://dx.doi.org/10.1186/s12893-022-01605-z
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