{Reference Type}: Journal Article
{Title}: Is the burden of metastatic lymph node stations a prognostic factor in patients with resected lung cancer?
{Author}: Çitak N;Erdogu V;Aksoy Y;Ciftci A;Yildiz N;İsgörücü Ö;Ozdemir S;Kose S;Ceylan KC;Metin M;
{Journal}: J Cardiothorac Surg
{Volume}: 19
{Issue}: 1
{Year}: 2024 Jul 3
{Factor}: 1.522
{DOI}: 10.1186/s13019-024-02874-w
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.