BACKGROUND: Accurate clinical staging of non-small cell lung cancer (NSCLC) is essential for developing an optimal treatment strategy. This study aimed to determine the predictive risk factors for lymph node metastasis, including both N1 and N2 metastases, in clinical T1aN0 NSCLC patients. METHODS: We retrospectively evaluated clinical T1aN0M0 NSCLC patients who showed no radiologic evidence of lymph node metastasis, and who had undergone surgical pulmonary resection with systematic mediastinal node dissection or sampling at the First Affiliated Hospital of Zhejiang University between January 2011 and June 2013. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for node metastasis. RESULTS: Pathologically positive lymph nodes were found in 16.2% (51/315) of the patients. Positive N1 nodes were found in 12.4% (39/315) of the patients, and positive N2 nodes were identified in 13.0% (41/315) of the patients. Some 9.2% (29/315) of the patients had both positive N1 and N2 nodes, and 3.8% (12/315) of the patients had nodal skip metastasis. Variables of preoperative radiographic tumor size, non-upper lobe located tumors, high carcinoembryonic antigen (CEA) levels and micropapillary predominant adenocarcinoma (AC) were identified as predictors for positive N1 or N2 node multivariate analysis. CONCLUSIONS: Pathologically positive lymph nodes were common in small size NSCLC patients with clinical negative lymph nodes. Therefore, preoperative staging should be performed more thoroughly to increase accuracy, especially for patients who have the larger size, non-upper lobe located, high CEA level or micropapillary predominant ACs.
BACKGROUND: Accurate clinical staging of non-small cell lung cancer (NSCLC) is essential for developing an optimal treatment strategy. This study aimed to determine the predictive risk factors for lymph node metastasis, including both N1 and N2 metastases, in clinical T1aN0 NSCLCpatients. METHODS: We retrospectively evaluated clinical T1aN0M0 NSCLCpatients who showed no radiologic evidence of lymph node metastasis, and who had undergone surgical pulmonary resection with systematic mediastinal node dissection or sampling at the First Affiliated Hospital of Zhejiang University between January 2011 and June 2013. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for node metastasis. RESULTS: Pathologically positive lymph nodes were found in 16.2% (51/315) of the patients. Positive N1 nodes were found in 12.4% (39/315) of the patients, and positive N2 nodes were identified in 13.0% (41/315) of the patients. Some 9.2% (29/315) of the patients had both positive N1 and N2 nodes, and 3.8% (12/315) of the patients had nodal skip metastasis. Variables of preoperative radiographic tumor size, non-upper lobe located tumors, high carcinoembryonic antigen (CEA) levels and micropapillary predominant adenocarcinoma (AC) were identified as predictors for positive N1 or N2 node multivariate analysis. CONCLUSIONS: Pathologically positive lymph nodes were common in small size NSCLCpatients with clinical negative lymph nodes. Therefore, preoperative staging should be performed more thoroughly to increase accuracy, especially for patients who have the larger size, non-upper lobe located, high CEA level or micropapillary predominant ACs.
Authors: Arne Warth; Thomas Muley; Michael Meister; Albrecht Stenzinger; Michael Thomas; Peter Schirmacher; Philipp A Schnabel; Jan Budczies; Hans Hoffmann; Wilko Weichert Journal: J Clin Oncol Date: 2012-03-05 Impact factor: 44.544
Authors: Giorgio V Scagliotti; Ugo Pastorino; Johan F Vansteenkiste; Lorenzo Spaggiari; Francesco Facciolo; Tadeusz M Orlowski; Luigi Maiorino; Martin Hetzel; Monika Leschinger; Carla Visseren-Grul; Valter Torri Journal: J Clin Oncol Date: 2011-11-28 Impact factor: 44.544
Authors: Amgad El-Sherif; William E Gooding; Ricardo Santos; Brian Pettiford; Peter F Ferson; Hiran C Fernando; Susan J Urda; James D Luketich; Rodney J Landreneau Journal: Ann Thorac Surg Date: 2006-08 Impact factor: 4.330
Authors: Emily A DuComb; Benjamin A Tonelli; Ya Tuo; Bernard F Cole; Vitor Mori; Jason H T Bates; George R Washko; Raúl San José Estépar; C Matthew Kinsey Journal: Chest Date: 2020-06-26 Impact factor: 9.410