小细胞肺癌(SCLC)患者的淋巴结(LN)状态可以预测其预后。作者旨在评估SCLC生存率与LN比值(LNR)数之间的相关性,正LN(pLNs),和正LN的对数赔率(LODDS)。
这项队列研究回顾性地纳入了2004-2015年SEER数据库中的1,762例SCLC患者。X-tile软件用于确定pLN的截止值,LNR,和LODDS。pLN之间的相关性,LNR,使用Cox回归分析探讨LODDS与总生存率(OS)和癌症特异性生存率(CSS)的关系。本研究使用C指数评估LNR的预测价值,pLNs,和生存的LODDS。
在这1762名患者中,121人(6.87%)活着,1641人(93.13%)死亡,1,532例(86.95%)死于SCLC。在单变量COX分析中,LNR,pLNs,和LODDS均与CSS和OS相关(p<0.05)。在多变量COX分析中,仅LODDS患者(>0.3vs.≤0.3)与较差的OS(HR=1.28,95%CI1.10-1.50)和CSS(HR=1.29,95%CI1.10-1.51)有关,但在LNR和pLN和生存率之间没有观察到校正(p>0.05)。预测LODDSOS的C指数为0.552(95%CI0.541~0.563),对于LNR0.504(95%CI0.501-0.507),和pLN0.527(95%CI0.514-0.540)。此外,SCLC患者的LODDS与预后之间的关联仅在LNN1和N2期患者中显著,而在N3期患者中不显著.
在预测SCLC患者的生存率方面,LODDS可能优于其他LN评估工具。
The prognosis of patients with Small Cell Lung Cancer (
SCLC) can be predicted by their Lymph Node (LN) status. The authors aimed to assess the correlations between
SCLC survival and number of LN Ratio (LNR), positive LN (pLNs), and Logarithmic Odds of positive LN (LODDS).
This cohort study retrospectively included 1,762 patients with
SCLC from the SEER database 2004‒2015. The X-tile software was used to determine the cutoff values for pLNs, LNR, and LODDS. The correlations between pLNs, LNR, and LODDS with Overall Survival (OS) and Cancer-Specific Survival (CSS) were explored using Cox regression analysis. The study used the C-index to assess the predictive value of LNR, pLNs, and LODDS on survival.
Among these 1,762 patients, 121 (6.87%) were alive, 1,641 (93.13%) died, and 1,532 (86.95%) died of
SCLC. In univariable COX analysis, LNR, pLNs, and LODDS all showed a correlation with CSS and OS (p < 0.05). In multivariable COX analysis, only patients with LODDS (> 0.3 vs. ≤ 0.3) were related to both worse OS (HR = 1.28, 95% CI 1.10‒1.50) and CSS (HR = 1.29, 95% CI 1.10‒1.51), but no correction was observed between LNR and pLNs and survival (p > 0.05). The C-indices for predicting OS for LODDS were 0.552 (95% CI 0.541‒0.563), for LNR 0.504 (95% CI 0.501‒0.507), and for pLNs 0.527 (95% CI 0.514‒0.540). Moreover, the association between LODDS and prognosis in SCLC patients was significant only in patients with LN stage N1 and N2, but not in stage N3.
LODDS may be better than other LN assessment tools at predicting survival in
SCLC patients.