The Effect of Examined Lymph Nodes and Lymph Node Ratio on Pathological Nodal Classification in the Lung Adenosquamous Carcinoma After Lobectomy

Frontiers in Surgery

article

Shoujie Feng¹  Xiangming Liu¹  Bing Huang³  Jing Shi⁴  Hao Zhang¹ 

[1] Department of Thoracic Surgery, Affiliated Hospital of Xuzhou Medical University;Thoracic Surgery Laboratory, Xuzhou Medical University;Department of Thoracic Surgery, Affiliated Huaihai Hospital of Xuzhou Medical University;Department of Radiology, Affiliated Huaihai Hospital of Xuzhou Medical University

关键词: adenosquamous carcinoma;    non-small cell lung cancer;    lymph node;    lymph node ratio;    survival;   

DOI  :  10.3389/fsurg.2022.909810

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective The effects of examined lymph nodes (LNs) and lymph node ratio (LNR) on pN classification and the prognosis are unclear in lung adenosquamous carcinoma (ASC) patients. Thus, this study aimed to investigate the significance of LNs and LNR in the prognosis of ASC and the impact of the abovementioned factors on the pN classification. Methods Patients diagnosed with pathological stage T1-4N0-2M0 ASC from the Surveillance Epidemiology and End Results database were included in the study. The primary clinical endpoint was cancer-specific survival (CSS). The optimal cutoff values of the LNs and LNR were determined. An LN indicator, including pN0 #LNs ≤9, pN0 #LNs >9, pN + #LNR ≤0.53, and pN + #LNR > 0.53, was developed. Concordance index (C-index) was used to compare the prognostic predictive ability between N classification and LN indicator. The univariable and multivariable Cox regression analyses were used in this study. Results The cohort of 1,416 patients were included in the study. The level of LNs stratified the patients without metastasis of lymph nodes (pN0 #LNs ≤9 vs. pN0 #LNs >9, unadjusted hazard ratio [HR] = 1.255, P  = 0.037). Two groups based on the cutoff value of LNR differentiated prognosis of patients with metastasis of lymph nodes (pN + #LNR >0.53 vs. pN + #LNR ≤0.53, unadjusted HR = 1.703, P  = 0.001). The LN indicator had a much better predictive ability over N classification in this cohort (LN indicator: C-index = 0.615; N classification: C-index = 0.602, P  = 0.001). Conclusions We explored clinicopathological factors affecting prognosis in resected lung ASC patients. Besides, the LN indicator was confirmed to be played an essential role in affecting the survival rate in ASC patients. The high-level LNs or low-level LNR might be corelated to improved survival outcomes.

【 授权许可】

CC BY