Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy

Cancers

卷:13

Isabella Sperduti¹  Felice Mucilli²  PierLuigi Filosso³  Giovannibattista Ratto⁴  Lorenzo Spaggiari⁵  Francesco Facciolo⁶  Giovanni Leuzzi⁷  Leonardo Petracca Ciavarella⁸  Emilio Bria⁸  Filippo Lococo⁸  Stefano Margaritora⁸  Marco Chiappetta⁸ 

[1]Biostatistics, Regina Elena National Cancer Institute—IRCCS, 00100 Rome, Italy

[2]|Department of General and Thoracic Surgery, University Hospital “SS. Annunziata”, 66100 Chieti, Italy

[3]|Department of Thoracic Surgery, University of Turin, San Giovanni Battista Hospital, 10126 Turin, Italy

[4]|Division of Thoracic Surgery, IRCCS AOU “San Martino” IST, 16132 Genoa, Italy

[5]|Thoracic Surgery Division, European Institute of Oncology, University of Milan, 20141 Milan, Italy

[6]|Thoracic Surgery, Regina Elena National Cancer Institute, 00100 Rome, Italy

[7]|Thoracic Surgery, Unit Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy

[8]|Università Cattolica del Sacro Cuore, 00168 Rome, Italy

关键词: NSCLC;    adenocarcinoma;    lymph node;    surgery;    adjuvant therapy;   

DOI  :  10.3390/cancers13061326

来源: DOAJ

【 摘 要 】

Background: Prognostic factors in patients with single mediastinal station (sN2) involvement continues to be a debated issue. Methods: Data on 213 adenocarcinoma patients with sN2 involvement and who had undergone complete anatomical lung resection and lymphadenectomy, were retrospectively reviewed. Clinical and pathological characteristics together with adjuvant therapy (AD) and node (N) status classifications (number of resected nodes (#RN), number of metastatic nodes (#MN), and node ratio (#MN/#RN = NR) were analyzed. Results: Univariable analysis confirmed that age (0.009), #MN (0.009), NR (0.003), #N1 involved stations (p = 0.003), and skip metastases (p = 0.005) were related to overall survival (OS). Multivariable analysis confirmed, as independent prognostic factors, age <66 years and NR with a three-year OS (3YOS) of 78.7% in NR < 10% vs. 46.6% in NR > 10%. In skip metastases, NR (HR 2.734, 95% CI 1.417–5.277, p = 0.003) and pT stage (HR2.136, 95% CI 1.001–4.557, p = 0.050) were confirmed as independent prognostic factors. AD did not influence the OS of patients with singular positive lymph nodes (p = 0.41), while in patients with multiple lymph nodes and AD, a significantly better 3YOS was demonstrated, i.e., 49.1% vs. 30% (p = 0.004). In patients with N2 + N1 involvement, age (p = 0.002) and AD (p = 0.022) were favorable prognostic factors. Conclusions: Adenocarcinoma patients with single N2 station involvement had a favorable outcome in the case of skip metastases and low NR. Adjuvant therapy improves survival with multiple nodal involvement, while its role in single node involvement should be clarified.

【 授权许可】

Unknown