Tabatabaei, Seyed Vahid, Nitche, Christoph, Michel, Maximilian ORCID: 0000-0002-5910-5363, Rasche, Kurt and Hekmat, Khosro (2018). Prognostic Impact of Extracapsular Lymph Node Invasion on Survival in Non-small-Cell Lung Cancer: A Systematic Review and Meta-analysis. In: Advances in Experimental Medicine and Biology, S. 27 - 37. CHAM: SPRINGER INTERNATIONAL PUBLISHING AG. ISBN 978-3-0300-4837-2

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Abstract

The extracapsular tumor extension (ECE) of nodal metastasis is an important prognostic factor in different types of malignancies. However, there is a lack of recent data in patients with non-small-cell lung cancer (NSCLC). In addition, the TNM staging system does not include ECE status as a prognostic factor. This systematic review and meta-analysis has been conducted to summarize and pool existing data to determine the prognostic role of ECE in patients with lymph node-positive NSCLC. Two authors performed an independent search in PubMed using a predefined keyword list, without language restrictions with publication date since 1990. Prospective or retrospective studies reporting data on prognostic parameters in subjects with NSCLC with positive ECE or with only intracapsular lymph node metastasis were retrieved. Data were summarized using risk ratios (RR) for the survival with 95% confidence intervals (CI). The data was analyzed using Mix 2 (ref: Bax L: MIX 2.0 - Professional software for meta-analysis in Excel. Version 2.015. BiostatXL, 2016. https://www.meta-analysis-made-easy.com). There 2,105 studies were reviewed. Five studies covering a total of 828 subjects met the inclusion criteria and were included in the meta-analysis. Two hundred and ninety-eight (35.9%) patients were categorized as ECE+, of whom 54 (18.1%) survived at the end of follow-up. In the ECE-negative group, 257 patients (48.4%) survived by the end of follow-up. Thus, ECE status is associated with a significantly decreased survival rate: pooled RR 0.45 (95% CI 0.35-0.59), Q(4) = 4.06, Pvalue = 0.39, and I-2 = 68.00% (95 CI 0.00-79.55%). In conclusion, ECE has a significant impact on survival in NSCLC patients and should be considered in diagnostic and therapeutic decisions in addition to the current TNM staging. Postoperative radiotherapy may be an option in ECE-positive pN1 NSCLC patients.

Item Type: Book Section, Proceedings Item or annotation in a legal commentary
Creators:
CreatorsEmailORCIDORCID Put Code
Tabatabaei, Seyed VahidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nitche, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Michel, MaximilianUNSPECIFIEDorcid.org/0000-0002-5910-5363UNSPECIFIED
Rasche, KurtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hekmat, KhosroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-199577
DOI: 10.1007/5584_2018_238
Title of Book: Advances in Experimental Medicine and Biology
Series Name: Adv.Exp.Med.Biol.
Volume: 1116
Page Range: S. 27 - 37
Date: 2018
Publisher: SPRINGER INTERNATIONAL PUBLISHING AG
Place of Publication: CHAM
ISSN: 2214-8019
ISBN: 978-3-0300-4837-2
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TNM CLASSIFICATION; DISTAL ESOPHAGUS; 7TH EDITION; METASTASES; CARCINOMA; INVOLVEMENT; RADIOTHERAPY; ADENOCARCINOMA; RECURRENCE; EXTENSIONMultiple languages
Medicine, Research & ExperimentalMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19957

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