Impact of the Extent of Lymph Node Dissection on Precise Staging and Survival in Clinical I–II Pure-Solid Lung Cancer Undergoing Lobectomy

医学 淋巴结切除术 危险系数 淋巴结 内科学 优势比 比例危险模型 肺癌 置信区间 解剖(医学) T级 淋巴 肿瘤科 阶段(地层学) 总体生存率 外科 病理 古生物学 生物
作者
Donglai Chen,Yiming Mao,Junmiao Wen,Jian Shu,Fei Ye,Yunlang She,Qifeng Ding,Li Shi,Tao Xue,Min Fan,Yongbing Chen,Chang Chen
出处
期刊:Journal of The National Comprehensive Cancer Network 卷期号:19 (4): 393-402 被引量:9
标识
DOI:10.6004/jnccn.2020.7635
摘要

This study sought to determine the optimal number of examined lymph nodes (ELNs) and examined node stations (ENSs) in patients with radiologically pure-solid non-small cell lung cancer (NSCLC) who underwent lobectomy and ipsilateral lymphadenectomy by investigating the impact of ELNs and ENSs on accurate staging and long-term survival.Data from 6 institutions in China on resected clinical stage I-II (cI-II) NSCLCs presenting as pure-solid tumors were analyzed for the impact of ELNs and ENSs on nodal upstaging, stage migration, recurrence-free survival (RFS), and overall survival (OS). Correlations between different endpoints and ELNs or ENSs were fitted with a LOWESS smoother, and the structural break points were determined by Chow test.Both ELNs and ENSs were identified as independent prognostic factors for OS (ENS hazard ratio [HR], 0.690; 95% CI, 0.597-0.797; P<.001; ELN HR, 0.950; 95% CI, 0.917-0.983; P=.004) and RFS (ENS HR, 0.859; 95% CI, 0.793-0.931; P<.001; ELN HR, 0.960; 95% CI, 0.942-0.962; P<.001), which were also associated with postoperative nodal upstaging (ENS odds ratio [OR], 1.057; 95% CI, 1.002-1.187; P=.004; ELN OR, 1.186; 95% CI, 1.148-1.226; P<.001). A greater number of ELNs and ENSs correlated with a higher accuracy of nodal staging and a lower probability of stage migration. Cut-point analysis revealed an optimal cutoff of 18 LNs and 6 node stations for stage cI-II pure-solid NSCLCs, which were validated in our multi-institutional cohort.Extensive examination of LNs and node stations seemed crucial to predicting accurate staging and survival outcomes. A threshold of 18 LNs and 6 node stations might be considered for evaluating the quality of LN examination in patients with stage cI-II radiologically pure-solid NSCLCs.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
MHCL完成签到 ,获得积分10
1秒前
哈基米德应助一颗小番茄采纳,获得30
1秒前
矮小的天菱完成签到,获得积分10
2秒前
长安发布了新的文献求助10
2秒前
5秒前
ddddddd完成签到,获得积分20
6秒前
章半仙完成签到,获得积分10
7秒前
8秒前
10秒前
amberzyc应助小远采纳,获得10
11秒前
qiongqiong完成签到,获得积分10
12秒前
淡定的依瑶完成签到,获得积分10
13秒前
江璃发布了新的文献求助10
15秒前
16秒前
17秒前
美丽的安珊完成签到,获得积分10
18秒前
18秒前
20秒前
Gilana完成签到,获得积分10
20秒前
xyh发布了新的文献求助10
20秒前
江璃完成签到,获得积分10
21秒前
TT发布了新的文献求助10
21秒前
美梦成真完成签到,获得积分10
22秒前
Gakay完成签到,获得积分10
22秒前
量子星尘发布了新的文献求助10
23秒前
szj完成签到,获得积分0
24秒前
旦皋完成签到,获得积分10
24秒前
赘婿应助花壳在逃野猪采纳,获得10
25秒前
卷卷完成签到,获得积分10
27秒前
JSY完成签到 ,获得积分20
27秒前
xyh完成签到,获得积分10
28秒前
小曾应助Florencia采纳,获得10
29秒前
神外王001完成签到 ,获得积分10
29秒前
34秒前
你是谁完成签到,获得积分10
35秒前
majf完成签到,获得积分10
36秒前
linhanwenzhou完成签到,获得积分10
36秒前
JSY关注了科研通微信公众号
36秒前
853225598完成签到,获得积分10
36秒前
798完成签到,获得积分10
37秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038368
求助须知:如何正确求助?哪些是违规求助? 3576068
关于积分的说明 11374313
捐赠科研通 3305780
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029