Bing Chen1,2,3, Wenjie Xia1,2,3, Zhongqiu Wang1,2, Heng Zhao4, Xiaofei Li5, Lunxu Liu6, Yang Liu7, Jian Hu8, Xiangning Fu9, Yin Li10, Yijun Xu11, Deruo Liu12, Haiying Yang13, Lin Xu14,15,16, Feng Jiang17,18,19. 1. Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, No.42, Baiziting, Xuanwu District, Nanjing, 210009, Jiangsu, China. 2. Department of Thoracic Surgery, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, 210009, China. 3. Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, Nanjing, 210009, China. 4. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, 200030, China. 5. Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China. 6. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China. 7. Department of Thoracic Surgery, Chinese People's Liberation Army General Hospital, Beijing, 1000853, China. 8. Department of Thoracic Surgery, First Hospital Affiliated to Medical College of Zhejiang University, Hangzhou, 310000, China. 9. Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. 10. Department of Thoracic Surgery, Henan Cancer Hospital, Zhengzhou, 450008, China. 11. Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300051, China. 12. Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, 100029, China. 13. Medical Affairs, Linkdoc Technology Co, Ltd, Beijing, 100080, China. 14. Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, No.42, Baiziting, Xuanwu District, Nanjing, 210009, Jiangsu, China. szl_xl@126.com. 15. Department of Thoracic Surgery, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, 210009, China. szl_xl@126.com. 16. Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, Nanjing, 210009, China. szl_xl@126.com. 17. Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, No.42, Baiziting, Xuanwu District, Nanjing, 210009, Jiangsu, China. zengnljf@hotmail.com. 18. Department of Thoracic Surgery, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, 210009, China. zengnljf@hotmail.com. 19. Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, Nanjing, 210009, China. zengnljf@hotmail.com.
Abstract
PURPOSE: N2 lymph-node metastases occur in approximately 6-17% of the patients with T1-2 non-small cell lung cancer (NSCLC). However, the clinical characteristics of N2 patients are not fully understood. METHODS: This retrospective, multi-center analysis included T1 NSCLC patients receiving surgical resection during a period from Jan 2nd, 2014 to Dec 27th, 2017. The diagnosis was pathologically verified in all cases. Univariate and multivariate logistic regression analyses were conducted to analyze the factors that are associated with pN2 lymph-node metastases. RESULTS: A total of 10,885 patients (48.4% men; 84.7% adenocarcinoma) were included in the analysis. The mean age was 59.0 ± 9.9 years. The mean tumor size was 1.8 ± 0.8 cm. Of the patients, 3260 (29.9%) were smokers or ex-smokers. Lymph-node metastases were verified in 1808 (16.6%) patients, and 1167 (10.7%) patients had N2 lymph-node metastases. The multivariate analyses indicated that larger tumor size, lower differentiation, CEA level ≥ 5 ng/mL, vascular invasion (+), and pleural involvement (+) were associated with higher percentages of N2 lymph-node metastases (p < 0.001 for all). CONCLUSIONS: This study demonstrated the significant association between N2 lymph-node metastases and tumor size and differentiation, CEA levels, and status of vascular invasion and pleural involvement.
PURPOSE: N2 lymph-node metastases occur in approximately 6-17% of the patients with T1-2 non-small cell lung cancer (NSCLC). However, the clinical characteristics of N2 patients are not fully understood. METHODS: This retrospective, multi-center analysis included T1 NSCLCpatients receiving surgical resection during a period from Jan 2nd, 2014 to Dec 27th, 2017. The diagnosis was pathologically verified in all cases. Univariate and multivariate logistic regression analyses were conducted to analyze the factors that are associated with pN2 lymph-node metastases. RESULTS: A total of 10,885 patients (48.4% men; 84.7% adenocarcinoma) were included in the analysis. The mean age was 59.0 ± 9.9 years. The mean tumor size was 1.8 ± 0.8 cm. Of the patients, 3260 (29.9%) were smokers or ex-smokers. Lymph-node metastases were verified in 1808 (16.6%) patients, and 1167 (10.7%) patients had N2 lymph-node metastases. The multivariate analyses indicated that larger tumor size, lower differentiation, CEA level ≥ 5 ng/mL, vascular invasion (+), and pleural involvement (+) were associated with higher percentages of N2 lymph-node metastases (p < 0.001 for all). CONCLUSIONS: This study demonstrated the significant association between N2 lymph-node metastases and tumor size and differentiation, CEA levels, and status of vascular invasion and pleural involvement.
Entities:
Keywords:
Chinese patients; N2 lymph-node metastases; Observational study; Risk factors; T1 non-small cell lung cancer
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