PDF(Pubmed)
Abstract：
OBJECTIVE: The burden of metastatic lymph node (LN) stations might reflect a distinct N subcategory with a more aggressive biology and behaviour than the traditional N classification.
METHODS: Between 2008 and 2018, we analyzed 1236 patients with pN1/2 lung cancer. Survival was analyzed based on LN station metastasis, determining the optimal threshold for the number of metastatic LN stations that provided additional prognostic information. N prognostic subgrouping was performed using thresholds for the number of metastatic LN stations with the maximum chi-square log-rank value, and validated at each pT-stage.
RESULTS: Survival showed stepwise statistical deterioration with an increase in the number of metastatic LN stations., Threshold values for the number of metastatic LN stations were determined and N prognostic subgroupswas created as sN-alpha; one LN station metastases (n = 632), sN-beta; two-three LN stations metastases (n = 505), and sN-gamma; ≥4 LN stations metastasis (n = 99). The 5-year survival rate was 57.7% for sN-alpha, 39.2% for sN-beta, and 12.7% for sN-gamma (chi-square log rank = 97.906, p < 0.001). A clear tendency of survival deterioration was observed from sN-alpha to sN-gamma in the same pT stage, except for pT4 stage. Multivariate analysis showed that age (p < 0.001), sex (p = 0.002), tumour histology (p < 0.001), IASLC-proposed N subclassification (p < 0.001), and sN prognostic subgroups (p < 0.001) were independent risk factors for survival.
CONCLUSIONS: The burden of metastatic LN stations is an independent prognostic factor for survival in patients with lung cancer. It could provide additional prognostic information to the N classification.
METHODS: Between 2008 and 2018, we analyzed 1236 patients with pN1/2 lung cancer. Survival was analyzed based on LN station metastasis, determining the optimal threshold for the number of metastatic LN stations that provided additional prognostic information. N prognostic subgrouping was performed using thresholds for the number of metastatic LN stations with the maximum chi-square log-rank value, and validated at each pT-stage.
RESULTS: Survival showed stepwise statistical deterioration with an increase in the number of metastatic LN stations., Threshold values for the number of metastatic LN stations were determined and N prognostic subgroupswas created as sN-alpha; one LN station metastases (n = 632), sN-beta; two-three LN stations metastases (n = 505), and sN-gamma; ≥4 LN stations metastasis (n = 99). The 5-year survival rate was 57.7% for sN-alpha, 39.2% for sN-beta, and 12.7% for sN-gamma (chi-square log rank = 97.906, p < 0.001). A clear tendency of survival deterioration was observed from sN-alpha to sN-gamma in the same pT stage, except for pT4 stage. Multivariate analysis showed that age (p < 0.001), sex (p = 0.002), tumour histology (p < 0.001), IASLC-proposed N subclassification (p < 0.001), and sN prognostic subgroups (p < 0.001) were independent risk factors for survival.
CONCLUSIONS: The burden of metastatic LN stations is an independent prognostic factor for survival in patients with lung cancer. It could provide additional prognostic information to the N classification.
摘要：
目的：转移性淋巴结（LN）站的负担可能反映了一个独特的N子类别，其生物学和行为比传统的N分类更具侵略性。
方法：在2008年至2018年之间，我们分析了1236例pN1/2肺癌患者。根据LN站转移分析生存率，确定提供额外预后信息的转移性LN站数量的最佳阈值。使用具有最大卡方log-rank值的转移性LN站数量的阈值进行N个预后分组，并在每个pT阶段进行验证。
结果：生存率显示随着转移性LN站数量的增加而逐步统计学恶化。,确定转移性LN站数量的阈值，并创建N个预后亚组作为sN-alpha；一个LN站转移（n=632），sN-β；2-3个LN站转移（n=505），和sN-γ；≥4个LN站转移（n=99）。sN-α的5年生存率为57.7%,sN-beta为39.2%，sN-gamma为12.7%(卡方对数秩=97.906，p<0.001)。在相同的pT阶段，从sN-α到sN-γ观察到明显的存活恶化趋势，除了pT4阶段。多因素分析显示，年龄(p<0.001)，性别（p=0.002），肿瘤组织学（p<0.001），IASLC提出的N子分类(p<0.001)，和sN个预后亚组（p<0.001）是生存的独立危险因素。
结论：转移性LN站的负担是肺癌患者生存的独立预后因素。它可以为N分类提供额外的预后信息。
方法：在2008年至2018年之间，我们分析了1236例pN1/2肺癌患者。根据LN站转移分析生存率，确定提供额外预后信息的转移性LN站数量的最佳阈值。使用具有最大卡方log-rank值的转移性LN站数量的阈值进行N个预后分组，并在每个pT阶段进行验证。
结果：生存率显示随着转移性LN站数量的增加而逐步统计学恶化。,确定转移性LN站数量的阈值，并创建N个预后亚组作为sN-alpha；一个LN站转移（n=632），sN-β；2-3个LN站转移（n=505），和sN-γ；≥4个LN站转移（n=99）。sN-α的5年生存率为57.7%,sN-beta为39.2%，sN-gamma为12.7%(卡方对数秩=97.906，p<0.001)。在相同的pT阶段，从sN-α到sN-γ观察到明显的存活恶化趋势，除了pT4阶段。多因素分析显示，年龄(p<0.001)，性别（p=0.002），肿瘤组织学（p<0.001），IASLC提出的N子分类(p<0.001)，和sN个预后亚组（p<0.001）是生存的独立危险因素。
结论：转移性LN站的负担是肺癌患者生存的独立预后因素。它可以为N分类提供额外的预后信息。
