Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer
ObjectivesSmall cell lung cancer (SCLC) is a lethal histologic subtype of lung cancer. Although the Commission on Cancer recommends pathological examination of at least 10 lymph nodes dissected (LNDs) for resected early-stage non-small cell lung cancer, its survival benefit of LNDs in patients with...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.962282/full |
| _version_ | 1811189347927457792 |
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| author | Shinkichi Takamori Takefumi Komiya Takefumi Komiya Emily Powell Emily Powell |
| author_facet | Shinkichi Takamori Takefumi Komiya Takefumi Komiya Emily Powell Emily Powell |
| author_sort | Shinkichi Takamori |
| collection | DOAJ |
| description | ObjectivesSmall cell lung cancer (SCLC) is a lethal histologic subtype of lung cancer. Although the Commission on Cancer recommends pathological examination of at least 10 lymph nodes dissected (LNDs) for resected early-stage non-small cell lung cancer, its survival benefit of LNDs in patients with early-stage SCLC is unknown.MethodsThe National Cancer Database was queried for SCLC patients with clinical stage I-II and clinical N0, NX disease per AJCC 7th edition who had undergone lobectomy between 2004 and 2017. Overall survival of SCLC patients by the number of LNDs was compared using Log-rank tests. Univariate and multivariable Cox proportional hazards analyses were performed.ResultsIn total, 688 (42%), 311 (20%), 247 (16%), 196 (12%), 126 (8%), and 36 (2%) of 1,584 patients with early-stage SCLC had ≥10, 7-9, 5-6, 3-4, 1-2, and 0 LNDs, respectively. The sequential improvement in the HRs was no longer evident if the number of LNDs exceeds 4. Patients with ≥3 LNDs (n = 1,422) had a significantly longer overall survival than those with <3 LNDs (n = 162) (hazard ratio for death: 0.76, 95% confidence interval: 0.62–0.94, P = 0.0087). Multivariate analysis revealed that ≥3 LNDs was an independent factor for predicting overall survival (hazard ratio for death: 0.76, 95% confidence interval: 0.61–0.93, P = 0.0083).ConclusionsAlthough we are reluctant to recommend a definitive “optimal number” of LNDs, our findings suggest the prognostic and therapeutic roles for performing ≥3 LNDs in patients with early-stage SCLC who undergo lobectomy. |
| first_indexed | 2024-04-11T14:33:26Z |
| format | Article |
| id | doaj.art-bb821ddd3f0e43e0b908a08a74803c81 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T14:33:26Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-bb821ddd3f0e43e0b908a08a74803c812022-12-22T04:18:26ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-11-011210.3389/fonc.2022.962282962282Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancerShinkichi Takamori0Takefumi Komiya1Takefumi Komiya2Emily Powell3Emily Powell4Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanMedical Oncology, Parkview Cancer Institute, Fort Wayne, IN, United StatesDivision of Hematology Oncology, University at Buffalo, Buffalo, NY, United StatesParkview Research Center, Mirro Center for Research and Innovation, Fort Wayne, IN, United StatesOncology Research Program, Parkview Cancer Institute, Fort Wayne, IN, United StatesObjectivesSmall cell lung cancer (SCLC) is a lethal histologic subtype of lung cancer. Although the Commission on Cancer recommends pathological examination of at least 10 lymph nodes dissected (LNDs) for resected early-stage non-small cell lung cancer, its survival benefit of LNDs in patients with early-stage SCLC is unknown.MethodsThe National Cancer Database was queried for SCLC patients with clinical stage I-II and clinical N0, NX disease per AJCC 7th edition who had undergone lobectomy between 2004 and 2017. Overall survival of SCLC patients by the number of LNDs was compared using Log-rank tests. Univariate and multivariable Cox proportional hazards analyses were performed.ResultsIn total, 688 (42%), 311 (20%), 247 (16%), 196 (12%), 126 (8%), and 36 (2%) of 1,584 patients with early-stage SCLC had ≥10, 7-9, 5-6, 3-4, 1-2, and 0 LNDs, respectively. The sequential improvement in the HRs was no longer evident if the number of LNDs exceeds 4. Patients with ≥3 LNDs (n = 1,422) had a significantly longer overall survival than those with <3 LNDs (n = 162) (hazard ratio for death: 0.76, 95% confidence interval: 0.62–0.94, P = 0.0087). Multivariate analysis revealed that ≥3 LNDs was an independent factor for predicting overall survival (hazard ratio for death: 0.76, 95% confidence interval: 0.61–0.93, P = 0.0083).ConclusionsAlthough we are reluctant to recommend a definitive “optimal number” of LNDs, our findings suggest the prognostic and therapeutic roles for performing ≥3 LNDs in patients with early-stage SCLC who undergo lobectomy.https://www.frontiersin.org/articles/10.3389/fonc.2022.962282/fullcancerprognosislung small cell lung cancerlymph node dissectionsurgerysurvival |
| spellingShingle | Shinkichi Takamori Takefumi Komiya Takefumi Komiya Emily Powell Emily Powell Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer Frontiers in Oncology cancer prognosis lung small cell lung cancer lymph node dissection surgery survival |
| title | Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer |
| title_full | Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer |
| title_fullStr | Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer |
| title_full_unstemmed | Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer |
| title_short | Clinical impact of number of lymph nodes dissected on postoperative survival in node-negative small cell lung cancer |
| title_sort | clinical impact of number of lymph nodes dissected on postoperative survival in node negative small cell lung cancer |
| topic | cancer prognosis lung small cell lung cancer lymph node dissection surgery survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.962282/full |
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