Schlachtenberger, Georg ORCID: 0000-0001-7118-8432, Doerr, Fabian, Menghesha, Hruy, Heldwein, Matthias B., Hagmeyer, Lars, Michel, Maximilian, Schaefer, Stephan C., Wahlers, Thorsten and Hekmat, Khosro (2021). Postoperative long-term survival of non-small cell lung cancer patients with skip-N2 metastases. Surg. Oncol.-Oxf., 38. OXFORD: ELSEVIER SCI LTD. ISSN 1879-3320
Full text not available from this repository.Abstract
Objective: Radical lymphadenectomy is crucial in operations for non-small cell lung cancer (NSCLC). Usually pN1 and pN2 lymph nodes are affected consecutively (N1N2). Nevertheless, pN2 metastases may also occur in the absence of pN1 as skip-N2 metastases (N0N2). Here we compare the long-term survival of N1N2- and N0N2 patients. Materials and methods: 464 patients underwent surgery for NSCLC at our institution between 2012 and 2017. We retrospectively reviewed data of pN2 stage patients (n = 68). Patients with N1N2 (n = 39) were compared to N0N2 (n = 29) patients. 1-, 3-and 5-year survival rates were measured. Survival was assessed by Kaplan-Meier curves and the cox proportional hazards model was used to identify prognostic factors for overall survival. All patients received adjuvant chemoradiation therapy according to European guidelines. Results: The baseline characteristics did not differ between groups. We observed no differences in the histology, localization, or gender in our cohort. N0N2 patients showed significantly better 1- (N1N2: 82.4% vs. N0N2 100%; p = 0.001), 3- (14.7% vs. 63.6%; p=<0.001) and 5-year (9.4% vs. 43.8%; p = 0.001) survival rates. Tumor size (Hazard ratio (HR) 1.46, Confidence interval (CI 95%) 1.03-2.04; p = 0.03) and the occurrence of N1N2 (HR 4.26, CI 2.04-8.91; p < 0.0001) were independent prognostic factors for worse long-term survival. The Kaplan-Meier curves showed a reduced overall survival for N1N2 patients (log-rank N1N2, N0N2 p < 0.0001). Conclusion: N1N2 patients have a significantly worse prognosis compared to N0N2 patients. This will aid to classify the heterogeneous pN2-NSCLC patient population more precisely. Further, multimodal therapy should be considered for N1N2 patients.
Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||||||
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URN: | urn:nbn:de:hbz:38-575944 | ||||||||||||||||||||||||||||||||||||||||
DOI: | 10.1016/j.suronc.2020.11.019 | ||||||||||||||||||||||||||||||||||||||||
Journal or Publication Title: | Surg. Oncol.-Oxf. | ||||||||||||||||||||||||||||||||||||||||
Volume: | 38 | ||||||||||||||||||||||||||||||||||||||||
Date: | 2021 | ||||||||||||||||||||||||||||||||||||||||
Publisher: | ELSEVIER SCI LTD | ||||||||||||||||||||||||||||||||||||||||
Place of Publication: | OXFORD | ||||||||||||||||||||||||||||||||||||||||
ISSN: | 1879-3320 | ||||||||||||||||||||||||||||||||||||||||
Language: | English | ||||||||||||||||||||||||||||||||||||||||
Faculty: | Unspecified | ||||||||||||||||||||||||||||||||||||||||
Divisions: | Unspecified | ||||||||||||||||||||||||||||||||||||||||
Subjects: | no entry | ||||||||||||||||||||||||||||||||||||||||
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URI: | http://kups.ub.uni-koeln.de/id/eprint/57594 |
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