Impact of visceral pleural invasion on the association of extent of lymphadenectomy and survival in stage I non-small cell lung cancer.
lung cancer
lymph node
survival
visceral pleural invasion
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
29
11
2018
revised:
26
12
2018
accepted:
05
01
2019
pubmed:
2
2
2019
medline:
27
3
2020
entrez:
2
2
2019
Statut:
ppublish
Résumé
Visceral pleural invasion (VPI) has been identified as an adverse prognostic factor for non-small cell lung cancer (NSCLC). Accurate nodal staging for NSCLC correlates with improved survival, but it is unclear whether tumors with VPI require a more extensive lymph nodes (LNs) dissection to optimize survival. We aimed to evaluate the impact of VPI status on the optimal extent of LNs dissection in stage I NSCLC, using the Surveillance, Epidemiology, and End Results (SEER) database. We identified 9297 surgically treated T1-2aN0M0 NSCLC patients with at least one examined LNs. Propensity score matching was conducted to balance the baseline clinicopathologic characteristics between the VPI group and non-VPI group. Log-rank tests along with Cox proportional hazards regression methods were performed to evaluate the impact of extent of LNs dissection on survival. VPI was correlated with a significant worse survival, but there was no significant difference in survival rate between PL1 and PL2. Patients who underwent sublobectomy had slightly decreased survival than those who underwent lobectomy. Pathologic LNs examination was significantly correlated with survival. Examination of 7-8 LNs and 14-16 LNs conferred the lowest hazard ratio for T1-sized/non-VPI tumors (stage IA) and T1-sized/VPI tumors (stage IB), respectively. The optimal extent of LNs dissection varied by VPI status, with T1-sized/VPI tumors (stage IB) requiring a more extensive LNs dissection than T1-sized/non-VPI tumors (stage IA). These results might provide guidelines for surgical procedure in early stage NSCLC.
Identifiants
pubmed: 30706688
doi: 10.1002/cam4.1990
pmc: PMC6382711
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
669-678Informations de copyright
© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
J Thorac Oncol. 2008 Aug;3(8):880-6
pubmed: 18670306
Ann Surg Oncol. 2014 Sep;21(9):2857-63
pubmed: 24740827
J Thorac Cardiovasc Surg. 2005 Jul;130(1):160-5
pubmed: 15999057
Lung Cancer. 2012 Nov;78(2):153-60
pubmed: 22944144
Chest. 1997 Jun;111(6):1710-7
pubmed: 9187198
Sci Rep. 2017 May 8;7(1):1527
pubmed: 28484235
J Thorac Oncol. 2016 Jan;11(1):39-51
pubmed: 26762738
J Thorac Oncol. 2015 Jul;10(7):990-1003
pubmed: 26134221
J Clin Oncol. 2017 Apr 10;35(11):1162-1170
pubmed: 28029318
J Surg Oncol. 2015 Mar;111(3):334-40
pubmed: 25322915
Int J Qual Health Care. 2018 May 1;30(4):276-282
pubmed: 29401300
JAMA Oncol. 2018 Jan 1;4(1):80-87
pubmed: 28973110
J Thorac Oncol. 2008 Dec;3(12):1384-90
pubmed: 19057261
J Thorac Dis. 2018 Apr;10(4):2357-2364
pubmed: 29850141
CA Cancer J Clin. 2018 Jan;68(1):7-30
pubmed: 29313949
Eur J Cardiothorac Surg. 2015 Nov;48(5):691-7; discussion 697
pubmed: 25564209
Ann Surg Oncol. 2012 Feb;19(2):661-8
pubmed: 21769464
World J Surg. 2017 Nov;41(11):2769-2777
pubmed: 28597091
Cancer Med. 2019 Feb;8(2):669-678
pubmed: 30706688
Am J Clin Oncol. 2018 Feb;41(2):152-158
pubmed: 26523443
Chest. 2012 Jul;142(1):141-150
pubmed: 22241763
Ann Thorac Surg. 2018 Aug;106(2):375-381
pubmed: 29580779
J Clin Oncol. 2003 Mar 15;21(6):1029-34
pubmed: 12637467
Ann Thorac Surg. 2016 Aug;102(2):363-9
pubmed: 27262908
Cancer. 2009 Feb 15;115(4):851-8
pubmed: 19140203
Ann Surg Oncol. 2017 May;24(5):1419-1427
pubmed: 28154950
Ann Surg Oncol. 2016 Dec;23(Suppl 5):1005-1011
pubmed: 27531307