Prognostic Significance of the Number of Lymph Nodes Removed at Lobectomy in Stage IA Non-small Cell Lung Cancer

Lobectomy with mediastinal lymph node dissection is the standard of care in stage IA non-small cell lung cancer (NSCLC). We investigated whether the number of lymph nodes removed influences survival in stage IA NSCLC patients who underwent lobectomy. 2545 stage IA NSCLC patients in the California Ca...

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Bibliographic Details
Published in:Journal of thoracic oncology 2008-08, Vol.3 (8), p.880-886
Main Authors: Ou, Sai-Hong Ignatius, Zell, Jason A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung - pathology
Carcinoma, Non-Small-Cell Lung - surgery
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Lobectomy
Lung Neoplasms - pathology
Lung Neoplasms - surgery
Lymph Node Excision
Lymph Nodes - pathology
Male
Middle Aged
Neoplasm Staging
Number of lymph nodes
Overall survival
Pneumonectomy
Prognosis
Retrospective Studies
Stage IA NSCLC
Survival Rate
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Summary:Lobectomy with mediastinal lymph node dissection is the standard of care in stage IA non-small cell lung cancer (NSCLC). We investigated whether the number of lymph nodes removed influences survival in stage IA NSCLC patients who underwent lobectomy. 2545 stage IA NSCLC patients in the California Cancer Registry who underwent lobectomy between 1999 and 2003 were analyzed. Cox proportional hazards regression was used to identify independent prognostic factors. Increasing number of lymph nodes removed was associated with statistical significant improvements in overall survival (OS) (p = 0.0001) and lung cancer-specific survival (LCSS) (p = 0.0309) of stage IA NSCLC patients who underwent lobectomy. The number of lymph nodes removed remained an independent favorable prognostic factor for OS (ptrend = 0.0001) and LCSS (ptrend = 0.0095) even after adjustment for other independent prognostic factors including age, sex, histology, histologic grade, socioeconomic status, and marital status in the Cox proportional regression analyses. Removal of 11 to 15 lymph nodes conferred the lowest hazard ratio for death [versus none; hazard ratio = 0.52; 95% confidence interval: 0.36–0.75]. The number of lymph nodes removed in stage IA NSCLC patients who underwent lobectomy is an independent prognostic factor for OS and LCSS.
ISSN:1556-0864
1556-1380
DOI:10.1097/JTO.0b013e31817dfced