Abstract
ABSTRACT Aim: Lymph node (LN) status is the most important prognostic factor in patients with resectable non-small cell lung cancer (NSCLC) who underwent radical surgery. However, the impact of total number of LNs being harvested during surgery on staging and overall survival (OS) remains controversial. In addition, the minimum count of LN that should be examined to accurately determine stage or identify high risk patients has not been recommended. Methods: A cohort of 5729 NSCLC patients from a multi-institutional registry in China (2001-2008) was collected to examine the relationship between harvested LN count and OS or staging. Subgroup analyses for patients with disease of different stages or histology types were proposed. An independent cohort of 546 patients from our center (2009-2010) on which the systematic LN dissection (SLND) was guaranteed was also examined to confirm the results. Results: Total number of LN examined was positively correlated with 5-year OS (R2 = 0.538, P = 0.016). Cut-point analysis identified the greatest survival difference at 14 LNs examined (k2 = 27.2) and survival analysis revealed significant longer median overall survival of patients being harvested for at least 14 LNs (100 vs. 73 months; P Conclusions: The current results suggested that more LN harvested favors OS in patients underwent radical resection for NSCLC. We recommended a minimum of 14 LNs should be harvested to accurately stage the disease and to improve patient survival. Disclosure: All authors have declared no conflicts of interest.
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