BACKGROUND: The number of resected lymph-nodes (#RNs) has proven prognostic in breast and colorectal cancer. Here we evaluated its prognostic impact in a series of resected NSCLC patients. METHODS: A panel of established prognostic factors plus (1) #RNs or (2) the ratio between the number of metastatic nodes and #RNs (NR) were correlated to overall- (OS), cancer-specific- (CSS), and disease-free-survival (DFS), using the Cox-model. Risk-classes according to hazard ratios (HR) were generated. Internal and external validation was accomplished. RESULTS: A dataset of 415 resected NSCLC patients was retrieved. At multivariate analysis, #RNs and NR were independent factor for longer OS, CSS and DFS (p<0.0001). Patients with a #RNs>10 (identified optimal cut-off) had a statistically significant OS (p=0.02) and DFS (p=0.0005) benefit. In node-positive patients, a NR<9% significantly correlated with better outcome. Stratification into High-, Medium-, and Low-Risk classes, based on High- (HRFs: stage, N-status, age, #RNs) and Intermediate-Risk Factors (IRFs: sex, grading, histology), efficiently predicted outcomes (p<0.0001). The risk class model performance was externally validated in and independent dataset of 297 patients. CONCLUSIONS: These results contribute to complete the panel of prognostic factors for resected NSCLC. A prospective larger validation and comparison with molecular prognostic tools is warranted.
BACKGROUND: The number of resected lymph-nodes (#RNs) has proven prognostic in breast and colorectal cancer. Here we evaluated its prognostic impact in a series of resected NSCLCpatients. METHODS: A panel of established prognostic factors plus (1) #RNs or (2) the ratio between the number of metastatic nodes and #RNs (NR) were correlated to overall- (OS), cancer-specific- (CSS), and disease-free-survival (DFS), using the Cox-model. Risk-classes according to hazard ratios (HR) were generated. Internal and external validation was accomplished. RESULTS: A dataset of 415 resected NSCLCpatients was retrieved. At multivariate analysis, #RNs and NR were independent factor for longer OS, CSS and DFS (p<0.0001). Patients with a #RNs>10 (identified optimal cut-off) had a statistically significant OS (p=0.02) and DFS (p=0.0005) benefit. In node-positive patients, a NR<9% significantly correlated with better outcome. Stratification into High-, Medium-, and Low-Risk classes, based on High- (HRFs: stage, N-status, age, #RNs) and Intermediate-Risk Factors (IRFs: sex, grading, histology), efficiently predicted outcomes (p<0.0001). The risk class model performance was externally validated in and independent dataset of 297 patients. CONCLUSIONS: These results contribute to complete the panel of prognostic factors for resected NSCLC. A prospective larger validation and comparison with molecular prognostic tools is warranted.
Authors: Ulas Kumbasar; Hilgardt Raubenheimer; May Al Sahaf; Nizar Asadi; Maria Elena Cufari; Chiara Proli; Periklis Perikleous; Zakiyah Niwaz; Emma Beddow; Vladimir Anikin; Niall McGonigle; Simon Jordan; George Ladas; Michael Dusmet; Eric Lim Journal: J Thorac Dis Date: 2016-01 Impact factor: 2.895
Authors: Chukwumere E Nwogu; Adrienne Groman; Daniel Fahey; Sai Yendamuri; Elisabeth Dexter; Todd L Demmy; Austin Miller; Mary Reid Journal: Ann Thorac Surg Date: 2012-03-20 Impact factor: 4.330
Authors: Qian Li; Ping Zhan; Dongmei Yuan; Tangfeng Lv; Alexander Sasha Krupnick; Antonio Passaro; Alessandro Brunelli; Matthew P Smeltzer; Raymond U Osarogiagbon; Yong Song Journal: Transl Lung Cancer Res Date: 2016-06
Authors: Ana María Gómez; Jose Ramón Jarabo Sarceda; Jose Antonio L García-Asenjo; Cristina Fernandez; Susana Hernandez; Julian Sanz; Elena Fernandez; Joaquin Calatayud; Antonio Torres; Florentino Hernando Journal: Tumour Biol Date: 2014-01-19
Authors: Onkar V Khullar; Theresa Gillespie; Dana C Nickleach; Yuan Liu; Kristin Higgins; Suresh Ramalingam; Joseph Lipscomb; Felix G Fernandez Journal: J Am Coll Surg Date: 2014-10-27 Impact factor: 6.113