Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter
Abstract Background Lung adenocarcinoma is the most common subtype of non-small cell lung cancer. The surgical strategy of lymph node dissection is controversial because many more patients are diagnosed at an early stage in clinical practice. Methods We retrospectively reviewed 622 clinical N0 lung...
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-022-01605-z |
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| author | Cheng Fang Yangwei Xiang Weili Han |
| author_facet | Cheng Fang Yangwei Xiang Weili Han |
| author_sort | Cheng Fang |
| collection | DOAJ |
| description | Abstract Background Lung adenocarcinoma is the most common subtype of non-small cell lung cancer. The surgical strategy of lymph node dissection is controversial because many more patients are diagnosed at an early stage in clinical practice. Methods We retrospectively reviewed 622 clinical N0 lung adenocarcinoma patients with 3 cm or less in tumor size who underwent lobectomy or segmentectomy combined with lymph node dissection in our hospital from January 2017 to December 2019. We performed univariate and multivariate analyses to identify preoperative risk factors of lymph node metastasis. Results Lymph node metastasis was found in 60 out of 622 patients. On univariate analysis, lymph node metastasis was linked to smoking history, preoperative CEA level, tumor size, tumor location (peripheral or central), consolidation/tumor ratio, pleural invasion, and pathologic type. However, only the preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors in multivariate analysis. The ROC curve showed that the cutoff value of tumor size was 1.7 cm. There was no lymph node metastasis in patients without risk factors. Conclusions The preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma with tumor size ≤ 3 cm. The lymph node metastasis rate was extremely low in clinical N0 lung adenocarcinoma patients without risk factors and lymph node dissection should be avoided in these patients to reduce surgical trauma. |
| first_indexed | 2024-04-13T03:59:03Z |
| format | Article |
| id | doaj.art-ba70ece45a594ee9841e0e9359dc901b |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-13T03:59:03Z |
| publishDate | 2022-04-01 |
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| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-ba70ece45a594ee9841e0e9359dc901b2022-12-22T03:03:32ZengBMCBMC Surgery1471-24822022-04-012211610.1186/s12893-022-01605-zPreoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameterCheng Fang0Yangwei Xiang1Weili Han2Department of Lung Transplantation, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Lung Transplantation, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Lung Transplantation, The First Affiliated Hospital, Zhejiang University School of MedicineAbstract Background Lung adenocarcinoma is the most common subtype of non-small cell lung cancer. The surgical strategy of lymph node dissection is controversial because many more patients are diagnosed at an early stage in clinical practice. Methods We retrospectively reviewed 622 clinical N0 lung adenocarcinoma patients with 3 cm or less in tumor size who underwent lobectomy or segmentectomy combined with lymph node dissection in our hospital from January 2017 to December 2019. We performed univariate and multivariate analyses to identify preoperative risk factors of lymph node metastasis. Results Lymph node metastasis was found in 60 out of 622 patients. On univariate analysis, lymph node metastasis was linked to smoking history, preoperative CEA level, tumor size, tumor location (peripheral or central), consolidation/tumor ratio, pleural invasion, and pathologic type. However, only the preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors in multivariate analysis. The ROC curve showed that the cutoff value of tumor size was 1.7 cm. There was no lymph node metastasis in patients without risk factors. Conclusions The preoperative CEA level, tumor size, and consolidation/tumor ratio were independent risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma with tumor size ≤ 3 cm. The lymph node metastasis rate was extremely low in clinical N0 lung adenocarcinoma patients without risk factors and lymph node dissection should be avoided in these patients to reduce surgical trauma.https://doi.org/10.1186/s12893-022-01605-zLung adenocarcinomaRisk factorLymph node metastasisLymph node dissection |
| spellingShingle | Cheng Fang Yangwei Xiang Weili Han Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter BMC Surgery Lung adenocarcinoma Risk factor Lymph node metastasis Lymph node dissection |
| title | Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter |
| title_full | Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter |
| title_fullStr | Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter |
| title_full_unstemmed | Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter |
| title_short | Preoperative risk factors of lymph node metastasis in clinical N0 lung adenocarcinoma of 3 cm or less in diameter |
| title_sort | preoperative risk factors of lymph node metastasis in clinical n0 lung adenocarcinoma of 3 cm or less in diameter |
| topic | Lung adenocarcinoma Risk factor Lymph node metastasis Lymph node dissection |
| url | https://doi.org/10.1186/s12893-022-01605-z |
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