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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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Published in: | Journal of thoracic oncology 2008-08, Vol.3 (8), p.880-886 |
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description | 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. |
doi_str_mv | 10.1097/JTO.0b013e31817dfced |
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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.</description><identifier>ISSN: 1556-0864</identifier><identifier>EISSN: 1556-1380</identifier><identifier>DOI: 10.1097/JTO.0b013e31817dfced</identifier><identifier>PMID: 18670306</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>Journal of thoracic oncology, 2008-08, Vol.3 (8), p.880-886</ispartof><rights>2008 International Association for the Study of Lung Cancer</rights><rights>2008International Association for the Study of Lung Cancer</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5171-42734780d8037fc6db4639eeb9fcb46cd5f52341116e6a9a9473d029534b01463</citedby><cites>FETCH-LOGICAL-c5171-42734780d8037fc6db4639eeb9fcb46cd5f52341116e6a9a9473d029534b01463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1556086415304524$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45759</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18670306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ou, Sai-Hong Ignatius</creatorcontrib><creatorcontrib>Zell, Jason A.</creatorcontrib><title>Prognostic Significance of the Number of Lymph Nodes Removed at Lobectomy in Stage IA Non-small Cell Lung Cancer</title><title>Journal of thoracic oncology</title><addtitle>J Thorac Oncol</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Lobectomy</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymph Node Excision</subject><subject>Lymph Nodes - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Number of lymph nodes</subject><subject>Overall survival</subject><subject>Pneumonectomy</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stage IA NSCLC</subject><subject>Survival Rate</subject><issn>1556-0864</issn><issn>1556-1380</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNp9kEFr3DAQhUVpadKk_6AUnXpzOrJkW7oUwtKmKSYpSXoWsjTeVWtbW8lO2H8fLbsQ6KGI0czAe4_hI-QDgwsGqvn84-H2AjpgHDmTrHG9RfeKnLKqqgvGJbw-ziBrcULepfQbQFQg5FtywmTdAIf6lGx_xrCeQpq9pfd-PfneWzNZpKGn8wbpzTJ2GPdbuxu3G3oTHCZ6h2N4REfNTNvQoZ3DuKN-ovezWSO9vsyyqUijGQa6wvy1y7Smq31uPCdvejMkfH_sZ-TXt68Pq-9Fe3t1vbpsC1uxhhWibLhoJDgJvOlt7TpRc4XYqd7m0bqqr0ouGGM11kYZJRruoFQVF5lJ1p6RT4fcbQx_F0yzHn2y-RgzYViSrhWXnJUqC8VBaGNIKWKvt9GPJu40A70nrTNp_S_pbPt4zF-6Ed2L6Yj2JfcpDDPG9GdYnjDqDZph3mhgpeBSiaIEkPkBFLkYy7YvBxtmOI8-O5L1mMk5HzNo7YL__2HPhZKe4g</recordid><startdate>200808</startdate><enddate>200808</enddate><creator>Ou, Sai-Hong Ignatius</creator><creator>Zell, Jason A.</creator><general>Elsevier Inc</general><general>International Association for the Study of Lung Cancer</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200808</creationdate><title>Prognostic Significance of the Number of Lymph Nodes Removed at Lobectomy in Stage IA Non-small Cell Lung Cancer</title><author>Ou, Sai-Hong Ignatius ; Zell, Jason A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5171-42734780d8037fc6db4639eeb9fcb46cd5f52341116e6a9a9473d029534b01463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Lobectomy</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Lymph Node Excision</topic><topic>Lymph Nodes - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Number of lymph nodes</topic><topic>Overall survival</topic><topic>Pneumonectomy</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Stage IA NSCLC</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ou, Sai-Hong Ignatius</creatorcontrib><creatorcontrib>Zell, Jason A.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thoracic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ou, Sai-Hong Ignatius</au><au>Zell, Jason A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Significance of the Number of Lymph Nodes Removed at Lobectomy in Stage IA Non-small Cell Lung Cancer</atitle><jtitle>Journal of thoracic oncology</jtitle><addtitle>J Thorac Oncol</addtitle><date>2008-08</date><risdate>2008</risdate><volume>3</volume><issue>8</issue><spage>880</spage><epage>886</epage><pages>880-886</pages><issn>1556-0864</issn><eissn>1556-1380</eissn><abstract>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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>18670306</pmid><doi>10.1097/JTO.0b013e31817dfced</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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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 |
title | Prognostic Significance of the Number of Lymph Nodes Removed at Lobectomy in Stage IA Non-small Cell Lung Cancer |
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