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. 2019 Jan 16;14(1):11.
doi: 10.1186/s13019-019-0831-0.

Predictive risk factors for lymph node metastasis in patients with resected non-small cell lung cancer: a case control study

Yusef Moulla  1 , Tanja Gradistanac  2 , Christian Wittekind  2 , Uwe Eichfeld  3 , Ines Gockel  3 , Arne Dietrich  3
Affiliations

Predictive risk factors for lymph node metastasis in patients with resected non-small cell lung cancer: a case control study

Yusef Moulla et al. J Cardiothorac Surg. .

Erratum in

Abstract

Background: Estimation of lymph node status is essential in order to determine precise therapy for patients with non-small cell lung cancer (NSCLC). Furthermore, lymph node involvement is a very powerful prognostic factor in these patients. In this analysis, we aim to evaluate the predictive factors for lymph node metastasis in NSCLC-patients.

Methods: In a prospectively-established database, we analyzed all data of patients with NSCLC, who underwent oncological surgical resections from 01/2007 to 12/2016, retrospectively. The correlation between clinicopathological parameters and lymph node metastasis was investigated by using univariate and binary logistic regression analysis.

Results: In this study, we operated on 204 consecutive patients, 142 men (71.7%) and 56 women (28.3%). Lymph node metastases were detected in 38.2% (78/204). Preoperatively, central tumor localization (OR = 2.6, 95% CI = 1.3-5.1, P = 0.005) and tumor size > 3 cm (OR = 2.5, 95% CI = 1.3-4.4, P = 0.005) were found to be significant predictive factors for lymph node metastasis. Postoperatively, multivariate analysis showed that intratumoral lymph vessel invasion (L1-status) (OR = 17.3, 95% CI = 5.1-58.4, P < 0.001) along with the central tumor localization (OR = 2.8, 95% CI = 1.4-5.8, P = 0.004) were significantly associated with lymph node metastasis. In small size tumors (≤3 cm), two predictive factors for lymph node metastasis were found: central tumor localization (OR = 19.4, 95% = 2.1-186.4, P = 0.01) and L1-status (OR = 43.9, 95% CI = 3.6-529.4, P = 0.003).

Conclusions: A precise pre- and intraoperative assessment of the lymph node status is essential in patients with larger sized tumors and central localization. Furthermore, L1-status is a highly significant risk factor for lymph node metastasis in NSCLC-Patients. Therefore, an adjuvant therapy in patients with L1-status and pNX category should be considered.

Keywords: Lymph node metastasis; Lymphatic vessel invasion; Non-small cell lung cancer (NSCLC).

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Figures

Fig. 1
Fig. 1
pN-category in patients with pT1-tumors according to predictive risk factors
Fig. 2
Fig. 2
Suggested algorithm to achieve a precise assessment of lymph node metastasis in NSCLC patients with risk factors
See this image and copyright information in PMC

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