Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer
Objectives: The ratio of positive and resected lymph nodes (LN ratio) has been shown to be prognostic in non-small cell lung cancer (NSCLC). Contrary to the LN ratio, calculating the LN log-odds ratio (LN-LOR) additionally considers the total number of resected lymph nodes. We aim to evaluate LN-LOR...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/7/2082 |
| _version_ | 1797608264806957056 |
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| author | Michal Benej Thomas Klikovits Tibor Krajc Tomas Bohanes Lisa Schulte Maximilian Johannes Hochmair Stefan Watzka Berta Mosleh Konrad Hoetzenecker Clemens Aigner Mir Alireza Hoda Michael Rolf Mueller |
| author_facet | Michal Benej Thomas Klikovits Tibor Krajc Tomas Bohanes Lisa Schulte Maximilian Johannes Hochmair Stefan Watzka Berta Mosleh Konrad Hoetzenecker Clemens Aigner Mir Alireza Hoda Michael Rolf Mueller |
| author_sort | Michal Benej |
| collection | DOAJ |
| description | Objectives: The ratio of positive and resected lymph nodes (LN ratio) has been shown to be prognostic in non-small cell lung cancer (NSCLC). Contrary to the LN ratio, calculating the LN log-odds ratio (LN-LOR) additionally considers the total number of resected lymph nodes. We aim to evaluate LN-LOR between positive and resected lymph nodes as a prognostic factor in operable NSCLC. Methods: Patients with NSCLC who underwent curative intent lobectomy treated at two high-volume centers were retrospectively studied. LN-LOR was dichotomized according to impact on OS and further combined with N descriptors and correlated with clinical variables and survival. Results: 944 patients were included. Cut-off analysis revealed that an LN-LOR of −0.34 significantly discriminated patients according to OS (<i>p</i> < 0.001, chi-squared test 41.26). When combined with N1 and N2 descriptors, LN-LOR low risk (median OS not reached and 83 months) and LN-LOR high-risk patients (median OS 50 and 59 months) had similar survival irrespective of the anatomical location of the positive lymph nodes. Multivariable Cox regression analysis revealed that age (HR 1.02, 95% CI 1.001–1.032), sex (male, HR 1.65, 95% CI 1.25–2.19), histological subtype (HR 2.11, 95% CI 1.35–3.29), pathological stage (HR 1.23, 95% CI 1.01–1.45) and LN-LOR risk groups (low risk, HR 0.48, 95% CI 0.32–0.72) were independent prognostic factors for OS. Conclusions: This retrospective two-center analysis shows that LN-LOR is significantly associated with OS in resectable NSCLC and might better reflect the biological behavior of the disease, regardless of anatomical lymph node locations. This finding may additionally support the value of extensive LN dissection. |
| first_indexed | 2024-03-11T05:41:11Z |
| format | Article |
| id | doaj.art-adc84d7166e84ddb8431099b0ac68cb5 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T05:41:11Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-adc84d7166e84ddb8431099b0ac68cb52023-11-17T16:25:52ZengMDPI AGCancers2072-66942023-03-01157208210.3390/cancers15072082Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung CancerMichal Benej0Thomas Klikovits1Tibor Krajc2Tomas Bohanes3Lisa Schulte4Maximilian Johannes Hochmair5Stefan Watzka6Berta Mosleh7Konrad Hoetzenecker8Clemens Aigner9Mir Alireza Hoda10Michael Rolf Mueller11Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaDepartment of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, AustriaObjectives: The ratio of positive and resected lymph nodes (LN ratio) has been shown to be prognostic in non-small cell lung cancer (NSCLC). Contrary to the LN ratio, calculating the LN log-odds ratio (LN-LOR) additionally considers the total number of resected lymph nodes. We aim to evaluate LN-LOR between positive and resected lymph nodes as a prognostic factor in operable NSCLC. Methods: Patients with NSCLC who underwent curative intent lobectomy treated at two high-volume centers were retrospectively studied. LN-LOR was dichotomized according to impact on OS and further combined with N descriptors and correlated with clinical variables and survival. Results: 944 patients were included. Cut-off analysis revealed that an LN-LOR of −0.34 significantly discriminated patients according to OS (<i>p</i> < 0.001, chi-squared test 41.26). When combined with N1 and N2 descriptors, LN-LOR low risk (median OS not reached and 83 months) and LN-LOR high-risk patients (median OS 50 and 59 months) had similar survival irrespective of the anatomical location of the positive lymph nodes. Multivariable Cox regression analysis revealed that age (HR 1.02, 95% CI 1.001–1.032), sex (male, HR 1.65, 95% CI 1.25–2.19), histological subtype (HR 2.11, 95% CI 1.35–3.29), pathological stage (HR 1.23, 95% CI 1.01–1.45) and LN-LOR risk groups (low risk, HR 0.48, 95% CI 0.32–0.72) were independent prognostic factors for OS. Conclusions: This retrospective two-center analysis shows that LN-LOR is significantly associated with OS in resectable NSCLC and might better reflect the biological behavior of the disease, regardless of anatomical lymph node locations. This finding may additionally support the value of extensive LN dissection.https://www.mdpi.com/2072-6694/15/7/2082non-small cell lung cancerprognosislymph node staginglog-odds ratiolobectomysurgery |
| spellingShingle | Michal Benej Thomas Klikovits Tibor Krajc Tomas Bohanes Lisa Schulte Maximilian Johannes Hochmair Stefan Watzka Berta Mosleh Konrad Hoetzenecker Clemens Aigner Mir Alireza Hoda Michael Rolf Mueller Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer Cancers non-small cell lung cancer prognosis lymph node staging log-odds ratio lobectomy surgery |
| title | Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer |
| title_full | Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer |
| title_fullStr | Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer |
| title_full_unstemmed | Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer |
| title_short | Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer |
| title_sort | lymph node log odds ratio accurately defines prognosis in resectable non small cell lung cancer |
| topic | non-small cell lung cancer prognosis lymph node staging log-odds ratio lobectomy surgery |
| url | https://www.mdpi.com/2072-6694/15/7/2082 |
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