Abstract
BackgroundFor patients with stage IA non-small cell lung cancer (NSCLC) with tumor size ≤ 2 cm, the prognostic significance of the number of removed lymph nodes (NLNs) through different surgical methods remains unclear. To determine the association of NLNs with cancer-specific survival (CSS) and overall survival (OS) in patients with stage IA NSCLC with tumor size ≤ 2 cm who underwent different lung surgeries.MethodsWe retrospectively enrolled 7293 patients from the Surveillance, Epidemiology and End Results database. Median NLNs was used to classify the patients into two groups: group A with NLNs ≤ 5 and group B with NLNs > 5. Propensity score matching (PSM) was performed to decrease selection bias. Kaplan–Meier analysis and Cox regression analysis were performed to identify the association between NLNs and survival outcomes.ResultsGroup B had better survival than group A in the unmatched cohort and matched cohort (all P < 0.05). Multivariable analyses revealed that the NLNs significantly affected CSS and OS of eligible cases in the unmatched cohort and matched cohort. Additionally, we found that the NLNs was a protective prognostic predictor of OS for patients who underwent wedge resection, segmental resection, or lobectomy.ConclusionThe NLNs was a protective prognostic factor in NSCLC patients with tumor size ≤ 2 cm. We demonstrated that patients with > 5 NLNs in the cohort of wedge resection, segmental resection, or lobectomy exhibited a significantly better OS.
Highlights
Lung cancer is one of the most aggressive malignancies worldwide
Patients with stage IA non-small-cell lung cancer (NSCLC) may undergo different surgical treatments, such as wedge resection, segmental resection, lobectomy, or pneumonectomy; their 5-year overall survival rate remains around 73–90% [2]
The patients were divided into two groups according to the median number of removed lymph nodes (NLNs)
Summary
Lung cancer is one of the most aggressive malignancies worldwide. In 2019, lung cancer accounted for 13% of all estimated new cancer cases and onequarter of all estimated cancer deaths in adults [1]. Multiple studies have indicated that LN resection conferred benefit in terms of the survival outcomes of patients with stage T1-4N0M0 NSCLC [4,5,6,7,8] It seems that the dissection of more number of LNs may result in a clearer TNM classification and improve the survival outcomes of patients [9, 10]. For patients with stage IA non-small cell lung cancer (NSCLC) with tumor size ≤ 2 cm, the prognostic significance of the number of removed lymph nodes (NLNs) through different surgical methods remains unclear. To determine the association of NLNs with cancer-specific survival (CSS) and overall survival (OS) in patients with stage IA NSCLC with tumor size ≤ 2 cm who underwent different lung surgeries
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