Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy
Background: Prognostic factors in patients with single mediastinal station (sN2) involvement continues to be a debated issue. Methods: Data on 213 adenocarcinoma patients with sN2 involvement and who had undergone complete anatomical lung resection and lymphadenectomy, were retrospectively reviewed....
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| Format: | Article |
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MDPI AG
2021-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/6/1326 |
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| author | Marco Chiappetta Filippo Lococo Giovanni Leuzzi Isabella Sperduti Emilio Bria Leonardo Petracca Ciavarella Felice Mucilli Pier Luigi Filosso Giovannibattista Ratto Lorenzo Spaggiari Francesco Facciolo Stefano Margaritora |
| author_facet | Marco Chiappetta Filippo Lococo Giovanni Leuzzi Isabella Sperduti Emilio Bria Leonardo Petracca Ciavarella Felice Mucilli Pier Luigi Filosso Giovannibattista Ratto Lorenzo Spaggiari Francesco Facciolo Stefano Margaritora |
| author_sort | Marco Chiappetta |
| collection | DOAJ |
| description | Background: Prognostic factors in patients with single mediastinal station (sN2) involvement continues to be a debated issue. Methods: Data on 213 adenocarcinoma patients with sN2 involvement and who had undergone complete anatomical lung resection and lymphadenectomy, were retrospectively reviewed. Clinical and pathological characteristics together with adjuvant therapy (AD) and node (N) status classifications (number of resected nodes (#RN), number of metastatic nodes (#MN), and node ratio (#MN/#RN = NR) were analyzed. Results: Univariable analysis confirmed that age (0.009), #MN (0.009), NR (0.003), #N1 involved stations (<i>p</i> = 0.003), and skip metastases (<i>p</i> = 0.005) were related to overall survival (OS). Multivariable analysis confirmed, as independent prognostic factors, age <66 years and NR with a three-year OS (3YOS) of 78.7% in NR < 10% vs. 46.6% in NR > 10%. In skip metastases, NR (HR 2.734, 95% CI 1.417–5.277, <i>p</i> = 0.003) and pT stage (HR2.136, 95% CI 1.001–4.557, <i>p</i> = 0.050) were confirmed as independent prognostic factors. AD did not influence the OS of patients with singular positive lymph nodes (<i>p</i> = 0.41), while in patients with multiple lymph nodes and AD, a significantly better 3YOS was demonstrated, i.e., 49.1% vs. 30% (<i>p</i> = 0.004). In patients with N2 + N1 involvement, age (<i>p</i> = 0.002) and AD (<i>p</i> = 0.022) were favorable prognostic factors. Conclusions: Adenocarcinoma patients with single N2 station involvement had a favorable outcome in the case of skip metastases and low NR. Adjuvant therapy improves survival with multiple nodal involvement, while its role in single node involvement should be clarified. |
| first_indexed | 2024-03-10T13:12:25Z |
| format | Article |
| id | doaj.art-3d09280bf4b7468fb8fd9c71ea7b84b0 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T13:12:25Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-3d09280bf4b7468fb8fd9c71ea7b84b02023-11-21T10:39:57ZengMDPI AGCancers2072-66942021-03-01136132610.3390/cancers13061326Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant TherapyMarco Chiappetta0Filippo Lococo1Giovanni Leuzzi2Isabella Sperduti3Emilio Bria4Leonardo Petracca Ciavarella5Felice Mucilli6Pier Luigi Filosso7Giovannibattista Ratto8Lorenzo Spaggiari9Francesco Facciolo10Stefano Margaritora11Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUniversità Cattolica del Sacro Cuore, 00168 Rome, ItalyThoracic Surgery, Unit Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyBiostatistics, Regina Elena National Cancer Institute—IRCCS, 00100 Rome, ItalyUniversità Cattolica del Sacro Cuore, 00168 Rome, ItalyUniversità Cattolica del Sacro Cuore, 00168 Rome, ItalyDepartment of General and Thoracic Surgery, University Hospital “SS. Annunziata”, 66100 Chieti, ItalyDepartment of Thoracic Surgery, University of Turin, San Giovanni Battista Hospital, 10126 Turin, ItalyDivision of Thoracic Surgery, IRCCS AOU “San Martino” IST, 16132 Genoa, ItalyThoracic Surgery Division, European Institute of Oncology, University of Milan, 20141 Milan, ItalyThoracic Surgery, Regina Elena National Cancer Institute, 00100 Rome, ItalyUniversità Cattolica del Sacro Cuore, 00168 Rome, ItalyBackground: Prognostic factors in patients with single mediastinal station (sN2) involvement continues to be a debated issue. Methods: Data on 213 adenocarcinoma patients with sN2 involvement and who had undergone complete anatomical lung resection and lymphadenectomy, were retrospectively reviewed. Clinical and pathological characteristics together with adjuvant therapy (AD) and node (N) status classifications (number of resected nodes (#RN), number of metastatic nodes (#MN), and node ratio (#MN/#RN = NR) were analyzed. Results: Univariable analysis confirmed that age (0.009), #MN (0.009), NR (0.003), #N1 involved stations (<i>p</i> = 0.003), and skip metastases (<i>p</i> = 0.005) were related to overall survival (OS). Multivariable analysis confirmed, as independent prognostic factors, age <66 years and NR with a three-year OS (3YOS) of 78.7% in NR < 10% vs. 46.6% in NR > 10%. In skip metastases, NR (HR 2.734, 95% CI 1.417–5.277, <i>p</i> = 0.003) and pT stage (HR2.136, 95% CI 1.001–4.557, <i>p</i> = 0.050) were confirmed as independent prognostic factors. AD did not influence the OS of patients with singular positive lymph nodes (<i>p</i> = 0.41), while in patients with multiple lymph nodes and AD, a significantly better 3YOS was demonstrated, i.e., 49.1% vs. 30% (<i>p</i> = 0.004). In patients with N2 + N1 involvement, age (<i>p</i> = 0.002) and AD (<i>p</i> = 0.022) were favorable prognostic factors. Conclusions: Adenocarcinoma patients with single N2 station involvement had a favorable outcome in the case of skip metastases and low NR. Adjuvant therapy improves survival with multiple nodal involvement, while its role in single node involvement should be clarified.https://www.mdpi.com/2072-6694/13/6/1326NSCLCadenocarcinomalymph nodesurgeryadjuvant therapy |
| spellingShingle | Marco Chiappetta Filippo Lococo Giovanni Leuzzi Isabella Sperduti Emilio Bria Leonardo Petracca Ciavarella Felice Mucilli Pier Luigi Filosso Giovannibattista Ratto Lorenzo Spaggiari Francesco Facciolo Stefano Margaritora Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy Cancers NSCLC adenocarcinoma lymph node surgery adjuvant therapy |
| title | Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy |
| title_full | Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy |
| title_fullStr | Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy |
| title_full_unstemmed | Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy |
| title_short | Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy |
| title_sort | survival analysis in single n2 station lung adenocarcinoma the prognostic role of involved lymph nodes and adjuvant therapy |
| topic | NSCLC adenocarcinoma lymph node surgery adjuvant therapy |
| url | https://www.mdpi.com/2072-6694/13/6/1326 |
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