F Xu1, C Wang, L Qi, W Yu, Q Li. 1. Key Laboratory of Cancer Prevention of Tianjin, Cancer Institute and Hospital of Tianjin Medical University, Huan Hu Xi Road, He Xi District, Tianjin, People's Republic of China.
Abstract
PURPOSE: Curative surgery remains the priority for treatment of stage IA non-small cell lung cancer (NSCLC). The purpose of this study is to investigate if the extent of lymph node (LN) dissections affect the prognosis of resected stage IA NSCLC. METHODS: A total of 110 stage IA NSCLC patients who underwent curative resections were reviewed. The patients were classified according to the number of lymph nodes dissected (N) and levels sampled (NL, N2). The tumor residuals of 2,251 LNs were detected by immunohistochemistry (IHC). The Flow Cytometry (FACS) of the peripheral blood (PB) and LNs was used to evaluate patients' immunity. The relationship between the studied factors and the correlation with disease-free survival (DFS) was analyzed. RESULTS: Disease free survival was improved as the extent of dissections increased in terms of N, NL and N2 (p = 0.005, <0.001, <0.001). Multivariate tests suggested N, N2 and NL (p = 0.001, 0.001, <0.001) were independent risk factors. However, the detection of tumor residuals also increased with the extent of dissection (p = 0.023, <0.001) while the presence of micrometastasis (MM) correlated with poor DFS (p = 0.028). Increased N represented weakened innate immunity (p = 0.048). Multivariate tests did not indicate a correlation between immunity and patients' DFS (p = 0.074). CONCLUSION: The more extensive lymph node dissections achieved better disease control for stage IA NSCLC. Greater retrieval of LNs did not imply enhanced innate immunity; nor did their immunity level affect survival.
PURPOSE: Curative surgery remains the priority for treatment of stage IA non-small cell lung cancer (NSCLC). The purpose of this study is to investigate if the extent of lymph node (LN) dissections affect the prognosis of resected stage IA NSCLC. METHODS: A total of 110 stage IA NSCLCpatients who underwent curative resections were reviewed. The patients were classified according to the number of lymph nodes dissected (N) and levels sampled (NL, N2). The tumor residuals of 2,251 LNs were detected by immunohistochemistry (IHC). The Flow Cytometry (FACS) of the peripheral blood (PB) and LNs was used to evaluate patients' immunity. The relationship between the studied factors and the correlation with disease-free survival (DFS) was analyzed. RESULTS: Disease free survival was improved as the extent of dissections increased in terms of N, NL and N2 (p = 0.005, <0.001, <0.001). Multivariate tests suggested N, N2 and NL (p = 0.001, 0.001, <0.001) were independent risk factors. However, the detection of tumor residuals also increased with the extent of dissection (p = 0.023, <0.001) while the presence of micrometastasis (MM) correlated with poor DFS (p = 0.028). Increased N represented weakened innate immunity (p = 0.048). Multivariate tests did not indicate a correlation between immunity and patients' DFS (p = 0.074). CONCLUSION: The more extensive lymph node dissections achieved better disease control for stage IA NSCLC. Greater retrieval of LNs did not imply enhanced innate immunity; nor did their immunity level affect survival.
Authors: Nicholas J Petrelli; Eric P Winer; Julie Brahmer; Sarita Dubey; Sonali Smith; Charles Thomas; Linda T Vahdat; Jennifer Obel; Nicholas Vogelzang; Maurie Markman; John W Sweetenham; David Pfister; Mark G Kris; Lynn M Schuchter; Raymond Sawaya; Derek Raghavan; Patricia A Ganz; Barnett Kramer Journal: J Clin Oncol Date: 2009-11-09 Impact factor: 44.544
Authors: Abel Gómez-Caro; Samuel Garcia; Noemí Reguart; Pedro Arguis; Marcelo Sanchez; Josep M Gimferrer; Ramon Marrades; Francisco Lomeña Journal: Eur J Cardiothorac Surg Date: 2010-01-29 Impact factor: 4.191
Authors: Gail E Darling; Mark S Allen; Paul A Decker; Karla Ballman; Richard A Malthaner; Richard I Inculet; David R Jones; Robert J McKenna; Rodney J Landreneau; Valerie W Rusch; Joe B Putnam Journal: J Thorac Cardiovasc Surg Date: 2011-03 Impact factor: 5.209