Alternative methods of lymph node staging in lung cancer: a narrative review
| Autor: | Marcin M Cackowski, Dariusz Dziedzic, Grzegorz M Gryszko, Marcin Zbytniewski, Tadeusz Orłowski |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Oncology medicine.medical_specialty business.industry medicine.medical_treatment Nodal staging Review Article 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Internal medicine medicine Narrative review Lymphadenectomy Lymph node staging Lymph Lung cancer NODAL business Lymph node |
| Zdroj: | J Thorac Dis |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd-20-1997 |
| Popis: | The nodal status indicator in non-small cell lung cancer is one of the most crucial prognostic factors available. However, there are still many arguments among scientists regarding whether the currently used nodal status descriptor should be changed in the forthcoming editions of the Tumor Node Metastasis classification or whether it is precise enough and should be maintained as is. We reviewed studies concerning nodal factor classifications to evaluate their accuracy in non-small cell lung cancer patients and to address the previously mentioned challenge. We reviewed the PubMed database regarding the following classifications: ongoing 8(th) edition of the Tumor Node Metastasis classification, number of positive lymph nodes, number of negative lymph nodes, number of dissected lymph nodes, lymph node ratio, nodal chains, log odds of positive lymph nodes, zone-based classification and one that is based on the number of lymph node stations involved. Moreover, we analysed data regarding various combinations of these classifications. Our analysis showed that the present nodal staging may not accurately categorize every lung cancer patient. The number of positive lymph nodes and lymph node ratio or the log odds of positive lymph nodes (as the mathematical modification of lymph node ratio) are more legitimate, as they possess very robust data and should be considered initially as additional factors that can be incorporated in ongoing nodal staging systems. Forthcoming non-small cell lung cancer staging systems could benefit from the addition of quantitative-based parameters. Additionally, the minimal extent of lymphadenectomy should be established as staging benefits from it. International, prospective validation studies need to be performed to optimize the cut-off values and prognostic groups and to confirm the superiority of the newly suggested descriptors in non-small cell lung cancer nodal staging. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|