Risk factors for recurrence after complete resection of pathological stage N2 non-small cell lung cancer
| Autor: | Bin Shi, Qiduo Yu, Zhiyi Song, Guangliang Qiang, Yongqing Guo, Deruo Liu, Yanchu Tian, Chaoyang Liang, Fei Xiao |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Univariate analysis Proportional hazards model business.industry Hazard ratio General Medicine medicine.disease Gastroenterology Primary tumor Surgery Metastasis Oncology Mediastinal lymph node Internal medicine medicine Stage (cooking) Lung cancer business |
| Zdroj: | Thoracic Cancer. 6:166-171 |
| ISSN: | 1759-7706 |
| DOI: | 10.1111/1759-7714.12159 |
| Popis: | BACKGROUND: Tumor recurrence is the most common cause of treatment failure, especially after complete resection of pathological stage N2 non-small cell lung cancer (NSCLC). In this study, we investigated the clinicopathological characteristics in order to identify independent risk factors for postoperative recurrence. METHODS: Between January 2001 and December 2013, 96 patients who underwent surgical resection for pathological N2 NSCLC were retrospectively reviewed. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method to explore risk factors, while the Cox proportional hazard model was used to assess independent predictors. RESULTS: The median and five-year RFS rates were 15 months and 27.4%, respectively. Univariate analysis showed a significantly poorer prognosis for non-regional N2 metastasis, more than three metastatic N2 lymph nodes, multiple N2 station, and multiple N2 zone involvement. Multivariate analysis demonstrated that non-regional N2 metastasis (hazard ratio [HR] 1.857, 95% confidence interval [CI] 1.061-3.249, P = 0.030) and more than three metastatic N2 lymph nodes (HR 2.555, 95% CI 1.164-5.606, P = 0.019) were independent risk factors for RFS. Additionally, the incidence of non-regional N2 metastasis was higher in patients with a primary tumor in the left lower (57.1%) or right lower lobe (48.1%), followed by left upper (31.8%), right middle (14.3%) and right upper lobe (7.7%). CONCLUSION: The combination of the distribution and number of metastatic N2 lymph nodes provides a more accurate prediction for N2 NSCLC regarding recurrence. Non-regional N2 metastasis could occur with a primary tumor in any lobe, but occurs more frequently in the lower lobe. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|