Jiajun Deng1, Yifan Zhong1, Tingting Wang2, Minglei Yang3,4, Minjie Ma5,6, Yongxiang Song7, Yunlang She8, Chang Chen9,10,11. 1. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200443, China. 2. Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. 3. Department of Thoracic Surgery, Hwa Mei Hospital, Chinese Academy of Sciences, Zhejiang, China. 4. Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo City, Zhejiang, China. 5. Department of Thoracic Surgery, The First Hospital of Lanzhou University, Gansu, China. 6. The International Science and Technology Cooperation Base for Development and Application of Key Technologies in Thoracic Surgery, Lanzhou, Gansu Province, China. 7. Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Medical College, Guizhou, China. 8. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200443, China. langthoracic@tongji.edu.cn. 9. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200443, China. changchenc@tongji.edu.cn. 10. Department of Thoracic Surgery, The First Hospital of Lanzhou University, Gansu, China. changchenc@tongji.edu.cn. 11. The International Science and Technology Cooperation Base for Development and Application of Key Technologies in Thoracic Surgery, Lanzhou, Gansu Province, China. changchenc@tongji.edu.cn.
Abstract
PURPOSE: To investigate the surgical prognosis and efficacy of adjuvant therapy in non-small cell lung cancer (NSCLC) with occult lymph node metastasis (ONM) defined by positron emission tomography/computed tomography (PET/CT). METHODS: A total of 3537 NSCLC patients receiving surgical resection were included in this study. The prognosis between patients with ONM and evident nodal metastasis, ONM patients with and without adjuvant therapy was compared, respectively. RESULTS: ONM was associated with significantly better prognosis than evident nodal metastasis whether for patients with N1 (5-year OS: 56.8% versus 52.3%, adjusted p value = 0.267; 5-year RFS: 44.7% versus 33.2%, adjusted p value = 0.031) or N2 metastasis (5-year OS: 42.8% versus 32.3%, adjusted p value = 0.010; 5-year RFS: 31.3% versus 21.6%, adjusted p value = 0.025). In ONM population, patients receiving adjuvant therapy yielded better prognosis comparing to those without adjuvant therapy (5-year OS: 50.1% versus 33.5%, adjusted p value < 0.001; 5-year RFS: 38.4% versus 22.1%, adjusted p value < 0.001). CONCLUSIONS: ONM defined by PET/CT identifies a unique clinical subtype of lung cancer, ONM is a favorable prognostic factor whether for pathological N1 or N2 NSCLC and adjuvant therapy could provide additional survival benefits for ONM patients.
PURPOSE: To investigate the surgical prognosis and efficacy of adjuvant therapy in non-small cell lung cancer (NSCLC) with occult lymph node metastasis (ONM) defined by positron emission tomography/computed tomography (PET/CT). METHODS: A total of 3537 NSCLC patients receiving surgical resection were included in this study. The prognosis between patients with ONM and evident nodal metastasis, ONM patients with and without adjuvant therapy was compared, respectively. RESULTS: ONM was associated with significantly better prognosis than evident nodal metastasis whether for patients with N1 (5-year OS: 56.8% versus 52.3%, adjusted p value = 0.267; 5-year RFS: 44.7% versus 33.2%, adjusted p value = 0.031) or N2 metastasis (5-year OS: 42.8% versus 32.3%, adjusted p value = 0.010; 5-year RFS: 31.3% versus 21.6%, adjusted p value = 0.025). In ONM population, patients receiving adjuvant therapy yielded better prognosis comparing to those without adjuvant therapy (5-year OS: 50.1% versus 33.5%, adjusted p value < 0.001; 5-year RFS: 38.4% versus 22.1%, adjusted p value < 0.001). CONCLUSIONS: ONM defined by PET/CT identifies a unique clinical subtype of lung cancer, ONM is a favorable prognostic factor whether for pathological N1 or N2 NSCLC and adjuvant therapy could provide additional survival benefits for ONM patients.
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