Gao Ting, Chang Yingxuan, Yue Hongmei
The First Clinical Medical College of Lanzhou University, Gansu, P.R. China; Department of Respiratory and Critical Care Medicine, Xianyang Central Hospital, Shaanxi, P.R. China.
The First Clinical Medical College of Lanzhou University, Gansu, P.R. China.
Clinics (Sao Paulo). 2024 May 1;79:100369. doi: 10.1016/j.clinsp.2024.100369. eCollection 2024.
The prognosis of patients with Small Cell Lung Cancer (SCLC) can be predicted by their Lymph Node (LN) status. The authors aimed to assess the correlations between SCLC survival and number of LN Ratio (LNR), positive LN (pLNs), and Logarithmic Odds of positive LN (LODDS).
This cohort study retrospectively included 1,762 patients with SCLC from the SEER database 2004‒2015. The X-tile software was used to determine the cutoff values for pLNs, LNR, and LODDS. The correlations between pLNs, LNR, and LODDS with Overall Survival (OS) and Cancer-Specific Survival (CSS) were explored using Cox regression analysis. The study used the C-index to assess the predictive value of LNR, pLNs, and LODDS on survival.
Among these 1,762 patients, 121 (6.87%) were alive, 1,641 (93.13%) died, and 1,532 (86.95%) died of SCLC. In univariable COX analysis, LNR, pLNs, and LODDS all showed a correlation with CSS and OS (p < 0.05). In multivariable COX analysis, only patients with LODDS (> 0.3 vs. ≤ 0.3) were related to both worse OS (HR = 1.28, 95% CI 1.10‒1.50) and CSS (HR = 1.29, 95% CI 1.10‒1.51), but no correction was observed between LNR and pLNs and survival (p > 0.05). The C-indices for predicting OS for LODDS were 0.552 (95% CI 0.541‒0.563), for LNR 0.504 (95% CI 0.501‒0.507), and for pLNs 0.527 (95% CI 0.514‒0.540). Moreover, the association between LODDS and prognosis in SCLC patients was significant only in patients with LN stage N1 and N2, but not in stage N3.
LODDS may be better than other LN assessment tools at predicting survival in SCLC patients.
小细胞肺癌（SCLC）患者的预后可通过其淋巴结（LN）状态来预测。作者旨在评估SCLC生存率与淋巴结比值（LNR）、阳性淋巴结（pLNs）以及阳性淋巴结对数优势比（LODDS）之间的相关性。
这项队列研究回顾性纳入了2004 - 2015年SEER数据库中的1762例SCLC患者。使用X-tile软件确定pLNs、LNR和LODDS的临界值。采用Cox回归分析探讨pLNs、LNR和LODDS与总生存期（OS）和癌症特异性生存期（CSS）之间的相关性。该研究使用C指数评估LNR、pLNs和LODDS对生存的预测价值。
在这1762例患者中，121例（6.87%）存活，1641例（93.13%）死亡，1532例（86.95%）死于SCLC。在单变量COX分析中，LNR、pLNs和LODDS均与CSS和OS相关（p < 0.05）。在多变量COX分析中，仅LODDS（> 0.3 vs. ≤ 0.3）的患者与较差的OS（HR = 1.28，95%CI 1.10 - 1.50）和CSS（HR = 1.29，95%CI 1.10 - 1.51）相关，但未观察到LNR和pLNs与生存之间的相关性（p > 0.05）。预测OS的LODDS的C指数为0.552（95%CI 0.541 - 0.563），LNR为0.504（95%CI 0.501 - 0.507），pLNs为0.527（95%CI 0.514 - 0.540）。此外，LODDS与SCLC患者预后之间的关联仅在LN分期为N1和N2的患者中显著，而在N3期患者中不显著。
在预测SCLC患者的生存方面，LODDS可能优于其他LN评估工具。
