PDF(Pubmed)
Abstract：
To investigate long-term outcomes and develop a risk model for pathological multi-station N2 (pN2b) in patients who underwent upfront surgery for clinical single-station N2 (cN2a) non-small cell lung cancer (NSCLC). From 2006 to 2018, 547 patients who had upfront surgery for suspected cN2a NSCLC underwent analysis. A risk model for predicting pN2b metastasis was developed using preoperative clinical variables via multivariable logistic analysis. Among 547 clinical cN2a NSCLC patients, 118 (21.6%), 58 (10.6%), and 371 (67.8%) had pN0, pN1, and pN2. Among 371 pN2 NSCLC patients, 77 (20.8%), 165 (44.5%), and 129 (34.7%) had pN2a1, pN2a2, and pN2b. The 5-year overall survival rates for pN2a1 and pN2a2 were significantly higher than for pN2b (p = 0.041). Histologic type (p < 0.001), age ≤ 50 years (p < 0.001), preoperatively confirmed N2 metastasis (p < 0.001), and clinical stage IIIB (vs. IIIA) (p = 0.003) were independent risk factors for pN2b metastasis. The risk scoring system based on this model demonstrated good discriminant ability for pN2b disease (area under receiver operating characteristic: 0.779). In cN2a NSCLC patients, those with multiple N2 metastases indicate worse prognosis than those with a single N2 metastasis. Our risk scoring system effectively predicts pN2b in these patients.
摘要：
探讨临床单站N2(cN2a)非小细胞肺癌(NSCLC)前期手术患者病理性多站N2(pN2b)的远期疗效，并建立其风险模型。从2006年到2018年，对547例疑似cN2aNSCLC进行了前期手术的患者进行了分析。通过多变量逻辑分析，使用术前临床变量建立了预测pN2b转移的风险模型。在547例临床cN2aNSCLC患者中，118（21.6%），58（10.6%），和371（67.8％）有pN0，pN1和pN2。在371名pN2非小细胞肺癌患者中，77（20.8%），165（44.5%），129例(34.7%)有pN2a1、pN2a2和pN2b。pN2a1和pN2a2的5年总生存率显著高于pN2b(p=0.041)。组织学类型（p<0.001），年龄≤50岁(p<0.001)，术前证实N2转移（p<0.001），和临床IIIB期(vs.IIIA）（p=0.003）是pN2b转移的独立危险因素。基于该模型的风险评分系统对pN2b疾病表现出良好的判别能力（接受者工作特征下的面积：0.779）。在cN2aNSCLC患者中，有多个N2转移的患者预后比单一N2转移的患者差.我们的风险评分系统有效地预测了这些患者的pN2b。
