Do skip-N2 metastases significantly impact overall survival and disease-free interval in N2 non-small-cell lung cancer patients? A multicentre analysis.

Autor:	Schlachtenberger G; Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany., Schallenberg S; Department of Pathology, Charité-Universitätsmedizin Berlin, Germany., Doerr F; Department of Thoracic Surgery, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Germany., Menghesha H; Department of Thoracic Surgery, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Germany., Gaisendrees C; Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany., Amorin A; Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany., Grathwohl C; Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany., Büttner R; Department of Pathology, University Hospital of Cologne, Germany., Quaas A; Department of Pathology, University Hospital of Cologne, Germany., Horst D; Department of Pathology, Charité-Universitätsmedizin Berlin, Germany., Klauschen F; Department of Pathology, Charité-Universitätsmedizin Berlin, Germany., Frost N; Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Germany., Rueckert JC; Department of Surgery, Charité-Universitätsmedizin Berlin, Germany., Neudecker J; Department of Surgery, Charité-Universitätsmedizin Berlin, Germany., Höpker K; University of Cologne, Faculty of Medicine, University Hospital Cologne, Clinic III for Internal Medicine, Germany., Wahlers T; Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany., Hekmat K; Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany., Heldwein MB; Department of Cardiothoracic Surgery, University Hospital of Cologne, Germany.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2023 Jul 03; Vol. 64 (1).
DOI:	10.1093/ejcts/ezad247
Abstrakt:	Objectives: Skip-N2 metastasis (N0N2), thus N2 metastasis in the absence of N1 metastasis, occurs in ∼20-30% of non-small-cell lung cancer patients. N0N2 patients have a better prognosis than continuous-N2 metastasis (N1N2) patients following surgery. However, this effect remains controversial. Therefore, we conducted a multicentre study to compare the long-term survival and disease-free interval (DFI) of N1N2- and N0N2 patients. Methods: One- and 3-year survival rates were measured. Kaplan-Meier curves and a Cox proportional hazards model assessed survival and were used to identify prognostic factors for overall survival. In addition, we performed propensity score matching (PSM) to rule out confounding factors. All patients received adjuvant chemoradiation therapy according to European guidelines. Results: Between January 2010 and December 2020, 218 stage IIIA/B N2 patients were included in our analysis. The Cox regression analysis revealed that N1N2 significantly influenced the overall survival rate. Before PSM, N1N2 patients showed significantly more metastatic lymph nodes (P < 0.001) and significantly larger tumours (P = 0.05). After PSM, baseline characteristics did not differ between groups. Before and after PSM, N0N2 patients showed significantly better 1- (P = 0.01; P = 0.009) and 3-year (P < 0.001) survival rates than N1N2 patients. Furthermore, N0N2 patients showed significantly longer DFI than N1N2 patients before and after PSM (P < 000.1). Conclusions: Prior and after PSM analysis, N0N2 patients were confirmed to have better survival and DFI than N1N2 patients. Our results demonstrate that stage IIIA/B N2 patients are heterogeneous and would benefit from a more precise subdivision and differential treatment. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu