Impact of number of positive regional lymph nodes in N1 stage on the prognosis of patients with non-small cell lung cancer: A propensity score matching study
- VernacularTitle:N1期区域淋巴结阳性数量对非小细胞肺癌患者预后影响的倾向性评分匹配研究
- Author:
Dandan LIU
1
,
2
;
Jiachen WANG
3
;
Lidan CHANG
2
;
Jia CHEN
4
;
Ranran KONG
1
;
Shiyuan LIU
1
;
Minxia ZHU
5
;
Jiantao JIANG
1
;
Shaomin LI
1
;
Zhengshui XU
1
Author Information
1. Department of Thoracic Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, P. R. China
2. Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, P. R. China
3. Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710001, P. R. China
4. Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, P. R. China
5. Department of Thoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, P. R. China
- Publication Type:Journal Article
- Keywords:
Non-small cell lung cancer;
N1 stage subclassification;
overall survival;
lung cancer-specific survival;
number of positive regional lymph nodes
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(01):63-71
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the impact of number of positive regional lymph nodes (nPRLN) in N1 stage on the prognosis of non-small cell lung cancer (NSCLC) patients. Methods Patients with TxN1M0 stage NSCLC who underwent lobectomy and mediastinal lymph node dissection from 2010 to 2015 were screened from SEER database (17 Regs, 2022nov sub). The optimal cutoff value of nPRLN was determined using X-tile software, and patients were divided into 2 groups according to the cutoff value: a nPRLN≤optimal cutoff group and a nPRLN>optimal cutoff group. The influence of confounding factors was minimized by propensity score matching (PSM) at a ratio of 1 : 1. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate overall survival (OS) and lung cancer-specific survival (LCSS) of patients. Results A total of 1316 patients with TxN1M0 stage NSCLC were included, including 662 males and 654 females, with a median age of 67 (60, 73) years. The optimal cutoff value of nPRLN was 3, with 1165 patients in the nPRLN≤3 group and 151 patients in the nPRLN>3 group. After PSM, there were 138 patients in each group. Regardless of before or after PSM, OS and LCSS of patients in the nPRLN≤3 group were superior to those in the nPRLN>3 group (P<0.001). N1 stage nPRLN>3 was an independent prognostic risk factor for OS [HR=1.52, 95%CI (1.22, 1.89), P<0.001] and LCSS [HR=1.72, 95%CI (1.36, 2.18), P<0.001]. Conclusion N1 stage nPRLN>3 is an independent prognostic risk factor for NSCLC patients in TxN1M0 stage, which may provide new evidence for future revision of TNM staging N1 stage subclassification.
