Prognostic Significance of the Highest Mediastinal Lymph Node Involvement in Patients with Stage III-N2 Non-small Cell Lung Cancer.
Ann Surg Oncol
; 31(8): 5028-5037, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38520577
ABSTRACT
BACKGROUND:
Highest mediastinal lymph node (HMLN) involvement is a category of uncertain resection, yet the prognostic significance of HMLN involvement remains controversial.METHODS:
A total of 486 patients with pathological stage III-N2 disease who underwent radical resection were enrolled from January 2015 to December 2018. Patients were allocated into two groups-HMLN involvement (219 cases) and HMLN-negative (249 cases) groups. Kaplan-Meier analysis and Cox proportional hazard regression models were used to evaluate the impact of HMLN involvement on 5-year recurrence-free survival (RFS) and overall survival (OS).RESULTS:
The proportion of patients with multiple N2 diseases (72.1% vs. 23.7%; p < 0.001) and stage IIIA (87.2% vs. 77.5%; p < 0.009) were greater in the HMLN-involvement group than in the HMLN-negative group, and the survival rates of the HMLN-involvement group were significantly lower than those of the HMLN-negative group (RFS 27.2% vs. 49.8%, p < 0.001; OS 42.1% vs. 59.2%, p = 0.001). HMLN status was an independent factor for OS only (RFS adjusted hazard ratio [aHR] 1.26, 95% confidence interval CI 0.94-1.68; OS aHR 1.45, 95% CI 1.07-1.99) in the entire stage III cohort. After stratification of patients according to stage, the involvement of HMLN decreased both RFS and OS in the stage IIIA group (RFS aHR 1.46, 95% CI 1.06-2.02; OS aHR 1.70, 95% CI 1.19-2.42); however, no such difference was observed within the stage IIIB group.CONCLUSIONS:
HMLN involvement is a prognostic factor of deteriorating survival in highly advanced N2 disease only in patients with stage IIIA.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Carcinoma Pulmonar de Células não Pequenas
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Neoplasias Pulmonares
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Linfonodos
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Metástase Linfática
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Mediastino
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Estadiamento de Neoplasias
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article