Qian Li1, Ping Zhan1, Dongmei Yuan1, Tangfeng Lv1, Alexander Sasha Krupnick1, Antonio Passaro1, Alessandro Brunelli1, Matthew P Smeltzer1, Raymond U Osarogiagbon1, Yong Song1. 1. 1 Department of Respiratory and Critical Care Medicine, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China ; 2 Division of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, USA ; 3 Division of Thoracic Oncology, European Institute of Oncology, Milan, Italy ; 4 Department of Thoracic Surgery, St. James's University Hospital in Leeds, UK ; 5 School of Public Health, University of Memphis, Memphis, TN, USA ; 6 Thoracic Oncology Research Group, Baptist Cancer Center, Memphis, TN, USA.
Abstract
BACKGROUND: Non-small cell lung cancer (NSCLC) patients with N1 disease have variable outcomes, and additional prognostic factors are needed. The number of positive lymph nodes (LNs) has been proposed as a prognostic indicator. However, the number of positive LNs depends on the number of LNs examined from the resection specimen. The lymph node ratio (LNR) can circumvent this limitation. The purpose of this study is to evaluate LNR as a predictor of survival and recurrence in patients with pathologic N1 NSCLC. METHODS: We systematically reviewed studies published before March 17, 2016, on the prognostic value of LNR in patients with pathologic N1 NSCLC. The hazard ratios (HRs) and their 95% confidence intervals (CIs) were used to combine the data. We also evaluated heterogeneity and publication bias. RESULTS: Five studies published between 2010 and 2014 were eligible for this systematic review with meta-analysis. The total number of patients included was 6,130 ranging from 75 to 4,004 patients per study. The combined HR for all eligible studies evaluating the overall survival (OS) and disease-free survival (DFS) of N1 LNR in patients with pathologic N1 NSCLC was 1.53 (95% CI: 1.22-1.85) and 1.64 (95% CI: 1.19-2.09), respectively. We found no heterogeneity and publication bias between the reports. CONCLUSIONS: LNR is a worthy predictor of survival and cancer recurrence in patients with pathological N1 NSCLC.
BACKGROUND:Non-small cell lung cancer (NSCLC) patients with N1 disease have variable outcomes, and additional prognostic factors are needed. The number of positive lymph nodes (LNs) has been proposed as a prognostic indicator. However, the number of positive LNs depends on the number of LNs examined from the resection specimen. The lymph node ratio (LNR) can circumvent this limitation. The purpose of this study is to evaluate LNR as a predictor of survival and recurrence in patients with pathologic N1 NSCLC. METHODS: We systematically reviewed studies published before March 17, 2016, on the prognostic value of LNR in patients with pathologic N1 NSCLC. The hazard ratios (HRs) and their 95% confidence intervals (CIs) were used to combine the data. We also evaluated heterogeneity and publication bias. RESULTS: Five studies published between 2010 and 2014 were eligible for this systematic review with meta-analysis. The total number of patients included was 6,130 ranging from 75 to 4,004 patients per study. The combined HR for all eligible studies evaluating the overall survival (OS) and disease-free survival (DFS) of N1 LNR in patients with pathologic N1 NSCLC was 1.53 (95% CI: 1.22-1.85) and 1.64 (95% CI: 1.19-2.09), respectively. We found no heterogeneity and publication bias between the reports. CONCLUSIONS: LNR is a worthy predictor of survival and cancer recurrence in patients with pathological N1 NSCLC.
Entities:
Keywords:
Lymph node ratio (LNR); N1 node, meta-analysis; non-small cell lung cancer (NSCLC)
Authors: Matthew P Smeltzer; Nicholas Faris; Xinhua Yu; Robert A Ramirez; Laura E M Ramirez; Christopher G Wang; Courtney Adair; Allen Berry; Raymond U Osarogiagbon Journal: Ann Thorac Surg Date: 2016-06-03 Impact factor: 4.330
Authors: Raymond U Osarogiagbon; Paul A Decker; Karla Ballman; Dennis Wigle; Mark S Allen; Gail E Darling Journal: Ann Thorac Surg Date: 2016-06-02 Impact factor: 4.330
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