Yang Liu1, Jianfei Shen2, Liping Liu3, Lanlan Shan4, Jiaxi He1, Qihua He1, Long Jiang1, Minzhang Guo1, Xuewei Chen1, Hui Pan1, Guilin Peng1, Honghui Shi1, Limin Ou3, Wenhua Liang1, Jianxing He1. 1. Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China. 2. Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, China. 3. The Translational Medicine Laboratory, State Key Laboratory of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China. 4. Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou 510120, China.
Abstract
BACKGROUND: The correlation between the number of examined lymph nodes (ELNs) and lung cancer-specific survival (LCSS) of stage IA non-small cell lung cancer (NSCLC) patients, who underwent sublobar resection in which lymph node (LN) sampling was relatively restricted as compared with standard lobectomy remains unclear. METHODS: Patients from the Surveillance, Epidemiology, and End Results database with stage IA NSCLC who underwent sublobar resection were categorized based on ELN count (1-6 vs. ≥7; the cut point 7 was identified by Cox model). RESULTS: Collectively, 3,219 patients with a median follow-up time of 37 months were included in this study (G1: 1-6 ELN, n=2,410; G2: ≥7 ELN, n=809). The 5-year LCSS rate of the G1 and G2 cohorts were 75% and 83%, respectively. Cox analysis suggested that the LCSS of G1 cohort patients was lower as compared with the G2 cohort [hazard ratio (HR) =1.530; 95% confidence interval (CI): 1.240-1.988, P<0.001). Propensity score analysis also showed decreased survival of the matched G1 cohort (HR =1.499; 95% CI: 1.176-1.911; P=0.001). CONCLUSIONS: The data suggested the ELNs ≤6 were associated with poor prognoses. Adequate LN sampling is essential even for stage IA NSCLC patients undergoing sublobar resection.
BACKGROUND: The correlation between the number of examined lymph nodes (ELNs) and lung cancer-specific survival (LCSS) of stage IA non-small cell lung cancer (NSCLC) patients, who underwent sublobar resection in which lymph node (LN) sampling was relatively restricted as compared with standard lobectomy remains unclear. METHODS: Patients from the Surveillance, Epidemiology, and End Results database with stage IA NSCLC who underwent sublobar resection were categorized based on ELN count (1-6 vs. ≥7; the cut point 7 was identified by Cox model). RESULTS: Collectively, 3,219 patients with a median follow-up time of 37 months were included in this study (G1: 1-6 ELN, n=2,410; G2: ≥7 ELN, n=809). The 5-year LCSS rate of the G1 and G2 cohorts were 75% and 83%, respectively. Cox analysis suggested that the LCSS of G1 cohort patients was lower as compared with the G2 cohort [hazard ratio (HR) =1.530; 95% confidence interval (CI): 1.240-1.988, P<0.001). Propensity score analysis also showed decreased survival of the matched G1 cohort (HR =1.499; 95% CI: 1.176-1.911; P=0.001). CONCLUSIONS: The data suggested the ELNs ≤6 were associated with poor prognoses. Adequate LN sampling is essential even for stage IA NSCLC patients undergoing sublobar resection.
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