What alters prognosis in patients who were operated for lung cancer with lymph node metastasis?

IF 1.6 4区医学 Q3 SURGERY ANZ Journal of Surgery Pub Date : 2024-08-28 DOI:10.1111/ans.19177

Berk Cimenoglu MD, Attila Ozdemir MD, Mesut Buz MD, Talha Dogruyol MD, Nedim Turan MD, Recep Demirhan MD

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Abstract

Introduction

In this study, we investigated the clinical outcomes of patients who underwent surgery with proven lymph node metastasis.

Methods

Patients who were operated for lung cancer with pN1 or pN2 were examined in the study. The clinicopathological features and survival of the subjects were evaluated according to pN1-pN2 status, presence of neoadjuvant treatment, Positron emission tomography and computed tomography (PET/CT) avidity on mediastinal lymph nodes and specific lymph node stations.

Results

The study examines 100 patients operated from January 2016 to December 2021. Number of cases with pN1 and pN2 disease were 45 (45%) and 55 (55%) respectively. Thirty (30%) patients received neoadjuvant treatment. The 5-year overall survival (OS) and disease-free survival (DFS) of the patients were computed as 42.5% and 42.4% correspondingly. The 5-year cancer-related survival was 55.3%. In pN2 cohort, 5-year DFS was 67.9% in the neoadjuvant group and 15.9% in the non-neoadjuvant group (P = 0.042). In non-neoadjuvant group, 5-year DFS was 19.9% in cases with mediastinal PET/CT avidity and 56.3% in patients without mediastinal PET/CT avidity (P = 0.018). In pN2 disease, the presence of subcarinal or paratracheal lymph node metastasis did not create a significant difference in 5-year OS or DFS, but pulmonary ligament lymph node metastasis was found to be linked with worse survival in both 5-year OS (P = 0.005) and DFS (P = 0.017).

Conclusion

The main elements related with poor prognosis were absence of neoadjuvant treatment and pulmonary ligament lymph node metastasis in pN2 disease, detecting PET/CT avid mediastinal lymph nodes in non-neoadjuvant group.

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是什么改变了肺癌淋巴结转移手术患者的预后？

导言本研究调查了已证实淋巴结转移的手术患者的临床疗效：方法：研究对象为pN1或pN2的肺癌手术患者。根据 pN1-pN2 状态、是否接受新辅助治疗、纵隔淋巴结的正电子发射计算机断层扫描（PET/CT）阳性率和特定淋巴结站，对受试者的临床病理特征和生存率进行评估：本研究对 2016 年 1 月至 2021 年 12 月期间接受手术的 100 例患者进行了调查。pN1和pN2病变的病例数分别为45例（45%）和55例（55%）。30例（30%）患者接受了新辅助治疗。患者的5年总生存率（OS）和无病生存率（DFS）分别为42.5%和42.4%。癌症相关的5年生存率为55.3%。在pN2队列中，新辅助组的5年无病生存率为67.9%，非新辅助组为15.9%（P = 0.042）。在非新辅助组中，纵隔PET/CT显像阳性病例的5年生存率为19.9%，无纵隔PET/CT显像阳性病例的5年生存率为56.3%（P = 0.018）。在pN2疾病中，心包下或气管旁淋巴结转移的存在对5年OS或DFS没有显著差异，但肺韧带淋巴结转移与5年OS（P = 0.005）和DFS（P = 0.017）生存率较差有关：结论：与预后不良有关的主要因素是未接受新辅助治疗和pN2病变中的肺韧带淋巴结转移，在未接受新辅助治疗组中检测到PET/CT高敏纵隔淋巴结。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ANZ Journal of Surgery 医学-外科

CiteScore

2.50

自引率

11.80%

发文量

720

审稿时长

2 months

期刊介绍： ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.