Abstract
BackgroundEstimation of lymph node status is essential in order to determine precise therapy for patients with non-small cell lung cancer (NSCLC). Furthermore, lymph node involvement is a very powerful prognostic factor in these patients. In this analysis, we aim to evaluate the predictive factors for lymph node metastasis in NSCLC-patients.MethodsIn a prospectively-established database, we analyzed all data of patients with NSCLC, who underwent oncological surgical resections from 01/2007 to 12/2016, retrospectively. The correlation between clinicopathological parameters and lymph node metastasis was investigated by using univariate and binary logistic regression analysis.ResultsIn this study, we operated on 204 consecutive patients, 142 men (71.7%) and 56 women (28.3%). Lymph node metastases were detected in 38.2% (78/204). Preoperatively, central tumor localization (OR = 2.6, 95% CI = 1.3–5.1, P = 0.005) and tumor size > 3 cm (OR = 2.5, 95% CI = 1.3–4.4, P = 0.005) were found to be significant predictive factors for lymph node metastasis. Postoperatively, multivariate analysis showed that intratumoral lymph vessel invasion (L1-status) (OR = 17.3, 95% CI = 5.1–58.4, P < 0.001) along with the central tumor localization (OR = 2.8, 95% CI = 1.4–5.8, P = 0.004) were significantly associated with lymph node metastasis. In small size tumors (≤3 cm), two predictive factors for lymph node metastasis were found: central tumor localization (OR = 19.4, 95% = 2.1–186.4, P = 0.01) and L1-status (OR = 43.9, 95% CI = 3.6–529.4, P = 0.003).ConclusionsA precise pre- and intraoperative assessment of the lymph node status is essential in patients with larger sized tumors and central localization. Furthermore, L1-status is a highly significant risk factor for lymph node metastasis in NSCLC-Patients. Therefore, an adjuvant therapy in patients with L1-status and pNX category should be considered.
Highlights
Estimation of lymph node status is essential in order to determine precise therapy for patients with non-small cell lung cancer (NSCLC)
We developed two models for the prediction of lymph node metastasis: The first one for the preoperative phase according to the radiologic und endoscopic findings, and the second one after the surgical resection according to the preoperative findings and the postoperative histopathological reports
According to the preoperative and postoperative findings, multivariate analysis revealed two significant predictive factors for lymph node metastasis: central tumor localization (OR = 2.8, 95% CI = 1.4–5.8, P = 0.004) and L1-status (OR = 17.3, 95% CI = 5.1–58.4, P < 0.001)
Summary
Estimation of lymph node status is essential in order to determine precise therapy for patients with non-small cell lung cancer (NSCLC). Lymph node involvement is a very powerful prognostic factor in these patients. In this analysis, we aim to evaluate the predictive factors for lymph node metastasis in NSCLC-patients. The main histological type of lung cancer is non-small lung cancer (NSCLC) (80–85%). The nodal status is considered as one of the most important prognostic factors in NSCLC-patients and, essential in determining the perioperative therapy [2]. Several techniques have been described to detect the clinical N-category, such as Moulla et al Journal of Cardiothoracic Surgery (2019) 14:11 identify predictive factors for lymph node metastasis in patients with NSCLC undergoing surgery
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