Significance of the number of positive lymph nodes and size of primary lesion for prognosis of resected non-small cell lung cancer
- Author:
Shun LU
1
Author Information
1. Shanghai Lung Tumor Clinical Medical Center
- Publication Type:Journal Article
- Keywords:
Carcinoma, non-small cell lung;
Lymphatic metastasis;
Neoplasm staging;
Prognosis
- From:
Tumor
2007;27(12):973-976
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the significance of the number of positive lymph nodes (LNs) and size of primary lesion for the prognosis of resected non small cell lung cancer (NSCLC). Methods: One hundred seventy-three NSCLC patients at pathological stage Ia-IIIa were recruited in this study. Fifty-nine patients received systematic lymphadenectomy and one hundred fourteen patients underwent limited lymph node sampling. The size of primary lesions was measured and the lymph vessel embolus was examined. The patients were divided according to the number of positive lymph nodes and size of primary lesions. The statistical analysis was performed by using SPSS 10.0 software. The survival function was analyzed by Kaplan-Meier method. COX regression model was used to analyze the multiple risk factors influencing the prognosis of NSCLC. Results: Totally 1 033 lymph nodes were resected in operation, mean(x̄ ± s) was 5.97 ± 0.20. There were 244 metastatic lymph nodes, mean(x̄ ± s) was 1.41 ± 0.16. Forty-five patients died. The 2-year survival rate was 71.9%. Survival analysis suggested that LNs were closely related with the prognosis of resected NSCLC. For the patients with pN2 disease, more positive LNs indicated poorer prognosis (P = 0.016). The survival difference was significant between the pN2 patients who had different numbers of metastatic station of mediastinal lymph nodes (P = 0.048). The difference was not significant between the pN2 patients with or without lymph node skip metastasis (P = 0.737). There was significant difference in survival time between the patients who had different sizes of primary lesions (< 3 cm; ≥3 cm and < 4 cm; ≥4 cm and <5 cm; ≥5 cm, P < 0.001). COX regression analysis showed that lymph vessel embolus was an important prognostic factor for resected NSCLC (P = 0.041). Conclusions: It will be beneficial to improve the international staging system of lung cancer by increasing the correlated definition on the number of positive LNs, making more detailed definition on the size of primary lesions and considering the influence of lymphatic vessel invasion on tumor staging.
