Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Surg Oncol. 2021 Jun;37:101513. doi: 10.1016/j.suronc.2020.12.007. Epub 2020 Dec 31.
OBJECTIVE(S): Lymph node status is vital for patients with small cell lung cancer (SCLC). We sought to evaluate the association between the number of lymph nodes examined (NLNE) and prognosis and nodal upstaging in stage I SCLC patients.
We queried the Surveillance, Epidemiology and End Results (SEER) database and our department for surgically treated patients with pathologic stage I SCLC to evaluate the correlation between NLNE and overall survival (OS). We further investigated the association between the NLNE and nodal upstaging in clinical stage I SCLC.
A total of 878 patients with pathologic stage I SCLC were enrolled from the SEER database. Univariate and multivariate Cox regression analysis revealed that removing more than 6 lymph nodes was associated with significantly improved OS. We validated the prognostic impact from examining more than 6 nodes in pathologic stage I SCLC patients from our department. Logistic regression analysis found that removing more than 6 nodes increased the odds of nodal upstaging for clinical stage I SCLC.
Adequate nodal examination leads to survival benefits and accurate nodal staging. Our analysis indicated that examining more than 6 lymph nodes could confer better OS and predict nodal upstaging for stage I SCLC patients.
淋巴结状态对小细胞肺癌（SCLC）患者至关重要。我们旨在评估检查的淋巴结数量（NLNE）与 I 期 SCLC 患者预后和淋巴结升级之间的关系。
我们查询了监测、流行病学和最终结果（SEER）数据库以及我们的科室，以评估病理 I 期 SCLC 患者 NLNE 与总生存期（OS）之间的相关性。我们进一步研究了 NLNE 与临床 I 期 SCLC 淋巴结升级之间的关系。
从 SEER 数据库共纳入 878 例病理 I 期 SCLC 患者。单因素和多因素 Cox 回归分析表明，切除 6 个以上淋巴结与显著改善 OS 相关。我们验证了从我们科室的病理 I 期 SCLC 患者中检查 6 个以上淋巴结对预后的影响。逻辑回归分析发现，切除 6 个以上淋巴结增加了临床 I 期 SCLC 患者淋巴结升级的几率。
充分的淋巴结检查可带来生存获益和准确的淋巴结分期。我们的分析表明，检查 6 个以上淋巴结可能为 I 期 SCLC 患者带来更好的 OS 并预测淋巴结升级。
