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Analysis of prognostic factors in pT1-2 N1 lung cancer patients in the light surgical results

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Abstract

Nodal metastasis status is an important parameter affecting the prognosis in lung cancer. Although surgical treatment is possible in most cases of N1 positive non-small cell lung cancer, this group of patients is clinically, radiologically and histologically heterogeneous. The aim of our study is to investigate the prognostic factors affecting survival in patients with pT1-2 N1 who underwent lung resection. From January 2010 to December 2019, patients who underwent lobectomy, bilobectomy or pneumonectomy for pT1-T2 N1 NSCLC in our center were included in the study. The preoperative, intraoperative and postoperative data of the patients were recorded by accessing the patient files and hospital records. The mean follow-up time was 39.8 months. The mean overall survival was 73.8 ± 3.6, and the mean disease-free survival was 67.5 ± 3.8. In multivariate analysis, age, N1 nodal metastasis pattern (occult vs obvious) and histology were found as independent variables affecting survival. In our study, age, histology, and clinical N1 status were found to be independent variables effective on overall survival.

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Data availability statement

The data that support the findings of this study are available from the corresponding author [GB], upon reasonable request.

References

  1. De Leyn P, Dooms C, Kuzdzal J, Lardinois D, Passlick B, Rami-Porta R, Turna A, Van Schil P, Venuta F, Waller D, Weder W, Zielinski M (2014) Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg 45(5):787–798

    Article  PubMed  Google Scholar 

  2. National comprehensive cancer network. NCCN clinical practice guidelines in oncology. Non-small cell lung cancer. https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed 7 Feb 2023

  3. Suzuki K, Nagai K, Yoshida J, Nishimura M, Takahashi K, Nishiwaki Y (1999) The prognosis of surgically resected N2 non-small cell lung cancer: the importance of clinical N status. J Thorac Cardiovasc Surg 118(1):145–153

    Article  CAS  PubMed  Google Scholar 

  4. Vansteenkiste JF, De Leyn PR, Deneffe GJ, Stalpaert G, Nackaerts KL, Lerut TE, Demedts MG (1997) Survival and prognostic factors in resected N2 non-small cell lung cancer: a study of 140 cases Leuven Lung Cancer Group. Ann Thorac Surg 63(5):1441–1450

    Article  CAS  PubMed  Google Scholar 

  5. Liu CY, Hung JJ, Wang BY, Hsu WH, Wu YC (2013) Prognostic factors in resected pathological N1-stage II nonsmall cell lung cancer. Eur Respir J 41(3):649–655

    Article  CAS  PubMed  Google Scholar 

  6. Nakao M, Yoshida J, Ishii G, Kawase A, Maeda R, Aokage K, Hishida T, Nishimura M, Nagai K (2010) Prognostic impact of node involvement pattern in pN1 non-small cell lung cancer patients. J Thorac Oncol 5(10):1576–1582

    Article  PubMed  Google Scholar 

  7. Rocco G, Nason K, Brunelli A, Varela G, Waddell T, Jones DR (2016) Management of stage IIIA (N2) non-small-cell lung cancer: a transatlantic perspective†. Eur J Cardiothorac Surg 49(4):1025–1027

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rena O (2016) The, “N”-factor in non-small cell lung cancer: staging system and institutional reports. J Thorac Dis 8(11):3049–3052

    Article  PubMed  PubMed Central  Google Scholar 

  9. Asamura H, Chansky K, Crowley J, Goldstraw P, Rusch VW, Vansteenkiste JF, Watanabe H, Wu YL, Zielinski M, Ball D, Rami-Porta R (2015) International association for the study of lung cancer staging and prognostic factors committee, advisory board members, and participating institutions. The IASLC lung cancer staging project: proposals for the revision of the N Descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 10:1675–1684

    Article  CAS  PubMed  Google Scholar 

  10. Jonnalagadda S, Smith C, Mhango G, Wisnivesky JP (2011) The number of lymph node metastases as a prognostic factor in patients with N1 non-small cell lung cancer. Chest 140(2):433–440

    Article  PubMed  PubMed Central  Google Scholar 

  11. Shimada Y, Tsuboi M, Saji H, Miyajima K, Usuda J, Uchida O, Kajiwara N, Ohira T, Hirano T, Kato H, Ikeda N (2009) The prognostic impact of main bronchial lymph node involvement in non-small cell lung carcinoma: suggestions for a modification of the staging system. Ann Thorac Surg 88(5):1583–1588

    Article  PubMed  Google Scholar 

  12. Robinson EM, Ilonen IK, Tan KS, Plodkowski AJ, Bott M, Bains MS, Adusumilli PS, Park BJ, Rusch VW, Jones DR, Huang J (2020) Prevalence of occult peribronchial N1 nodal metastasis in peripheral clinical N0 small (≤2 cm) non-small cell lung cancer. Ann Thorac Surg 109(1):270–276

    Article  PubMed  Google Scholar 

  13. Beyaz F, Verhoeven RLJ, Schuurbiers OCJ, Verhagen AFTM, van der Heijden EHFM (2020) Occult lymph node metastases in clinical N0/N1 NSCLC; A single center in-depth analysis. Lung Cancer 150:186–194

    Article  PubMed  Google Scholar 

  14. Garelli E, Renaud S, Falcoz PE, Weingertner N, Olland A, Santelmo N, Massard G (2016) Microscopic N2 disease exhibits a better prognosis in resected non-small-cell lung cancer. Eur J Cardiothorac Surg 50(2):322–328

    Article  PubMed  Google Scholar 

  15. Lee MC, Hsu CP (2017) Surgery in microscopically pathological N2 non-small cell lung cancer: the size of lymph node matters. J Thorac Dis 9(2):230–232

    Article  PubMed  PubMed Central  Google Scholar 

  16. Holmes EC (1987) Treatment of stage II lung cancer (T1N1 and T2N1). Surg Clin North Am 67(5):945–949

    Article  CAS  PubMed  Google Scholar 

  17. Ichinose Y, Yano T, Asoh H, Yokoyama H, Yoshino I, Katsuda Y (1995) Prognostic factors obtained by a pathologic examination in completely resected non-small-cell lung cancer. An analysis in each pathologic stage. J Thorac Cardiovasc Surg 110(3):601–605

    Article  CAS  PubMed  Google Scholar 

  18. Artal Cortés Á, Calera Urquizu L, Hernando CJ (2015) Adjuvant chemotherapy in non-small cell lung cancer: state-of-the-art. Transl Lung Cancer Res 4(2):191–197

    PubMed  PubMed Central  Google Scholar 

  19. Pignon JP, Tribodet H, Scagliotti GV, Douillard JY, Shepherd FA, Dunant RJS et al (2008) Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE collaborative group. J Clin Oncol 26:3552–3559

    Article  PubMed  Google Scholar 

  20. Liang Y, Wakelee HA (2013) Adjuvant chemotherapy of completely resected early stage non-small cell lung cancer (NSCLC). Transl Lung Cancer Res 2(5):403–410

    CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

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Authors and Affiliations

  1. Department of Thoracic Surgery, Kars State Hospital, Yenişehir, Ismail Aytemiz Street 55, 36002, Kars, Turkey

    Güntuğ Batıhan

  2. University of Health Sciences Turkey, Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Turkey

    Kenan Can Ceylan, Ahmet Üçvet, Şeyda Örs Kaya & Serkan Yazgan

Authors
  1. Güntuğ Batıhan
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  2. Kenan Can Ceylan
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  3. Ahmet Üçvet
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  4. Şeyda Örs Kaya
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  5. Serkan Yazgan
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Contributions

GB: conceptualization; data curation; formal analysis; investigation; methodology; supervision; writing—review & editing. KCC: conceptualization; data curation; investigation; methodology; project administration; writing—original draft; writing—review & editing. AU: conceptualization; data curation; formal analysis; investigation; methodology; supervision; writing—original draft; writing—review & editing. SOK: conceptualization; investigation; methodology; project administration; writing—original draft; writing—review & editing. SY: conceptualization; methodology; project administration; writing—original draft; writing—review & editing.

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Correspondence to Güntuğ Batıhan.

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Research involving human participants and/or animals, and Informed consent

This retrospective study was approved by the local ethics committee and informed consent was obtained from all individual participants included in the study.

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The authors declare that there is no conflict of interest, and this research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Batıhan, G., Ceylan, K.C., Üçvet, A. et al. Analysis of prognostic factors in pT1-2 N1 lung cancer patients in the light surgical results. Updates Surg 75, 1011–1017 (2023). https://doi.org/10.1007/s13304-023-01473-z

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  • DOI: https://doi.org/10.1007/s13304-023-01473-z

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