Jae Han Jeong1, Nae Yu Kim2, Jung-Soo Pyo3. 1. Department of Thoracic and Cardiovascular surgery, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Republic of Korea. 2. Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea; Study group for meta-analysis, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea. 3. Department of Pathology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea; Study group for meta-analysis, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea. Electronic address: anapyojs@gmail.com.
Abstract
OBJECTIVE: This study aimed to confirm the prognostic roles of lymph node (LN) micrometastasis (LNMM) in non-small cell lung cancer (NSCLC) through a meta-analysis. METHODS: This study included 2026 NSCLC cases without detection of LN metastasis in histologic examination. We investigated the detection rate of LNMM in early-stage NSCLC and analyzed the correlation between LNMM and the rates of recurrence and survival. RESULTS: The range of detection rates of LNMM was 3.8-68.8% in the eligible studies. The detection rate of LNMM in early-stage NSCLC was 25.3% (95% confidence interval [CI] 19.8-31.6%). In subgroup analysis based on detection method, polymerase chain reaction method had higher detection rate than immunohistochemistry (33.7%, 95% CI 25.5-43.0% vs. 23.1%, 95% CI 18.0-29.0%). The presence of LNMM was significantly correlated with a higher recurrence rate (odds ratio 3.913, 95% CI 1.595-9.600, P=0.003). In addition, there were significant correlations between LNMM and worse overall and disease-free survival rates (hazard ratio [HR] 2.345, 95% CI 1.863-2.951, and HR 1.606, 95% CI 1.170-2.206, respectively). CONCLUSION: Taken together, our results showed that LNMM was detected in 25.3% of NSCLCs without nodal disease through ancillary test. In addition, the presence of LNMM was significantly correlated with a higher recurrence rate and worse survival rates in early-stage NSCLC.
OBJECTIVE: This study aimed to confirm the prognostic roles of lymph node (LN) micrometastasis (LNMM) in non-small cell lung cancer (NSCLC) through a meta-analysis. METHODS: This study included 2026 NSCLC cases without detection of LN metastasis in histologic examination. We investigated the detection rate of LNMM in early-stage NSCLC and analyzed the correlation between LNMM and the rates of recurrence and survival. RESULTS: The range of detection rates of LNMM was 3.8-68.8% in the eligible studies. The detection rate of LNMM in early-stage NSCLC was 25.3% (95% confidence interval [CI] 19.8-31.6%). In subgroup analysis based on detection method, polymerase chain reaction method had higher detection rate than immunohistochemistry (33.7%, 95% CI 25.5-43.0% vs. 23.1%, 95% CI 18.0-29.0%). The presence of LNMM was significantly correlated with a higher recurrence rate (odds ratio 3.913, 95% CI 1.595-9.600, P=0.003). In addition, there were significant correlations between LNMM and worse overall and disease-free survival rates (hazard ratio [HR] 2.345, 95% CI 1.863-2.951, and HR 1.606, 95% CI 1.170-2.206, respectively). CONCLUSION: Taken together, our results showed that LNMM was detected in 25.3% of NSCLCs without nodal disease through ancillary test. In addition, the presence of LNMM was significantly correlated with a higher recurrence rate and worse survival rates in early-stage NSCLC.
Authors: Jill F Mentink; Marthe S Paats; Daphne W Dumoulin; Robin Cornelissen; Joris B W Elbers; Alexander P W M Maat; Jan H von der Thüsen; Anne-Marie C Dingemans Journal: Transl Lung Cancer Res Date: 2021-07