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Assessing Differences in Lymph Node Metastasis Based Upon Sex in Early Non-Small Cell Lung Cancer

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Abstract

Backgrounds

Whether sex has any impact on the risk of lymph node (LN) metastasis (LNM) in patients with early-stage non-small cell lung cancer (NSCLC) remains controversial. Therefore, we aimed to objectively compared the risk of LNM between female and male patients with early-stage NSCLC so as to figure out whether sex-different extent of surgery may be justified for treating these patients.

Methods

We retrospectively collected clinical data of patients undergoing lobectomy or segmentectomy with systematic hilar and mediastinal LN dissection for clinical stage IA peripheral NSCLC from June 2014 to April 2019. Both multivariate logistic regression analysis and propensity score-matched(PSM) analysis were applied to compare the risk of LNM between female and male patients.

Results

We finally included a total of 660 patients for analysis. In the analysis of unmatched cohorts, there was no significant different rate of LNM (12.4% Vs 13.9%, P=0.556), hilar/intrapulmonary LNM (8.4% Vs 10.7%, P=0.318) and mediastinal LNM(7.9% Vs 7.5%, P=0.851) between female and male patients. In the multivariate analysis, sex was not found to be an independent predictor of LN in these patients. Moreover, in the analysis of well-matched cohorts generated by PSM analysis, there was still no significant different rate of LNM (13.8% Vs 13.4%, P=0.892), hilar/intrapulmonary LNM (9.1% Vs 11.2%, P=0.442) and mediastinal LNM (9.1% Vs 6.5%, P=0.289) between female and male patients.

Conclusions

Sex was not an independent predictor of LNM in early-stage NSCLC and there is no sufficient evidence justifying for sex-different extent of surgical resection for these patients.

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Author information

Authors and Affiliations

  1. Lung Cancer Center, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China

    Han-Yu Deng, Xiao-Ming Qiu, Da-Xing Zhu, Xiao-Jun Tang & Qinghua Zhou

  2. Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China

    Chang Liu

Authors
  1. Han-Yu Deng
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  2. Chang Liu
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  3. Xiao-Ming Qiu
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  4. Da-Xing Zhu
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  5. Xiao-Jun Tang
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  6. Qinghua Zhou
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Contributions

Han-Yu Deng and Chang Liu collected data and drafted the manuscript. Han-Yu Deng and Xiao-Ming Qiu analyzed the data. Han-Yu Deng and Qinghua Zhou designed the study. Xiao-Ming Qiu, Da-Xing Zhu, and Xiao-Jun Tang, and Qinghua Zhou revised the manuscript. All authors read and approved the final manuscript. Han-Yu Deng and Chang Liu contributed equally to the study and were co-first authors.

Corresponding author

Correspondence to Qinghua Zhou.

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The authors declared that they have no conflict of interest.

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Deng, HY., Liu, C., Qiu, XM. et al. Assessing Differences in Lymph Node Metastasis Based Upon Sex in Early Non-Small Cell Lung Cancer. World J Surg 45, 2610–2618 (2021). https://doi.org/10.1007/s00268-021-06136-x

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  • DOI: https://doi.org/10.1007/s00268-021-06136-x

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