Zhang Yanan, Liu Zhehui, Wang Hongmin, Liang Fengfan, Zhu Liqiong, Liu Haifeng
Department of Geriatrics, Liaocheng People's Hospital, Shandong First Medical University, Liaocheng, Shandong, China.
Joint Laboratory for Translational Medicine Research, Liaocheng People's Hospital, Shandong First Medical University, Liaocheng, Shandong, China.
Front Oncol. 2022 Oct 21;12:990540. doi: 10.3389/fonc.2022.990540. eCollection 2022.
This study aims to analyze the prognostic significance of the metastatic lymph node (mLN) size in non-small cell lung cancer (NSCLC) patients receiving chemoradiotherapy (CRT) to provide some information for the optimization of clinical nodal (cN) staging.
A retrospective study with 325 NSCLC patients was conducted between January 2011 and December 2018 at two participating institutes. We evaluated the potential relationship between the mLN size and the survival to propose a potential revised nodal (rN) staging.
Kaplan-Meier analyses showed significant differences in the overall survival (OS) based on the cN staging and the size of mLNs (N0, ≤2 cm, and >2 cm). We found that the nodal size correlated statistically with the response to CRT. The HRs of OS for patients with bulky mLNs increase significantly compared with patients in the non-bulky mLNs group in the cN2-3 group. Interestingly, the HRs of patients with bulky cN2 disease and non-bulky cN3 disease were similar to each other. We classified the patients into five subsets: N0, rN1(cN1), rN2(non-bulky cN2), rN3a(bulky cN2, and non-bulky cN3), and rN3b(bulky cN3). In our study, the rN stage showed better prognostic discrimination than the 8th IASLC cN staging and was an independent prognostic factor for survival.
In addition to the anatomic location, the size of mLNs correlated statistically with the response to CRT and should be incorporated into the cN staging system to predict survival more accurately.
本研究旨在分析接受放化疗（CRT）的非小细胞肺癌（NSCLC）患者中转移淋巴结（mLN）大小的预后意义，为优化临床淋巴结（cN）分期提供一些信息。
2011年1月至2018年12月期间，在两家参与研究的机构对325例NSCLC患者进行了一项回顾性研究。我们评估了mLN大小与生存率之间的潜在关系，以提出一种潜在的修订淋巴结（rN）分期。
Kaplan-Meier分析显示，基于cN分期和mLN大小（N0、≤2 cm和>2 cm）的总生存期（OS）存在显著差异。我们发现淋巴结大小与CRT反应在统计学上相关。与cN2-3组中淋巴结不大的患者相比，淋巴结大的患者的OS风险比显著增加。有趣的是，淋巴结大的cN2疾病患者和淋巴结不大的cN3疾病患者的风险比彼此相似。我们将患者分为五个亚组：N0、rN1（cN1）、rN2（淋巴结不大的cN2）、rN3a（淋巴结大的cN2和淋巴结不大的cN3）和rN3b（淋巴结大的cN3）。在我们的研究中，rN分期显示出比第8版IASLC cN分期更好的预后区分能力，并且是生存的独立预后因素。
除了解剖位置外，mLN大小与CRT反应在统计学上相关，应纳入cN分期系统以更准确地预测生存。
