Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry

doi:10.1200/JCO.2016.67.5140

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	Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry
	Liang, Wenhua 1,2,3; He, Jiaxi 1,2,3; Shen, Yaxing 7; Shen, Jianfei 1,2,3,6; He, Qihua 1,2,3; Zhang, Jianrong 1,2,3; Jiang, Gening 8; Wang, Qun 7; Liu, Lunxu 10; Gao, Shugeng 11,12,13; Liu, Deruo 14; Wang, Zheng 17; Zhu, Zhihua 4; Ng, Calvin S. H.18; Liu, Chia-chuan 21; Petersen, Rene Horsleben 22; Rocco, Gaetano 23; D'Amico, Thomas 24; Brunelli, Alessandro 25; Chen, Haiquan 9; Zhi, Xiuyi 15; Liu, Bo16 ; Yang, Yixin 16; Chen, Wensen 19,20; Zhou, Qian 5; He, Jianxing 1,2,3
	2017-04-10
发表期刊	JOURNAL OF CLINICAL ONCOLOGY
ISSN	0732-183X
卷号	35 期号:11 页码:1162-1170
摘要	Purpose We investigated the correlation between the number of examined lymph nodes (ELNs) and correct staging and long-term survival in non-small-cell lung cancer (NSCLC) by using large databases and determined the minimal threshold for the ELN count. Methods Data from a Chinese multi-institutional registry and the US SEER database on stage I to IIIA resected NSCLC (2001 to 2008) were analyzed for the relationship between the ELN count and stage migration and overall survival (OS) by using multivariable models. The series of the mean positive LNs, odds ratios (ORs), and hazard ratios (HRs) were fitted with a LOWESS smoother, and the structural break points were determined by Chow test. The selected cut point was validated with the SEER 2009 cohort. Results Although the distribution of ELN count differed between the Chinese registry (n = 5,706) and the SEER database (n = 38,806; median, 15 versus seven, respectively), both cohorts exhibited significantly proportional increases from N0 to N1 and N2 disease (SEER OR, 1.038; China OR, 1.012; both P < .001) and serial improvements in OS (N0 disease: SEER HR, 0.986; China HR, 0.981; both P < .001; N1 and N2 disease: SEER HR, 0.989; China HR, 0.984; both P,.001) as the ELN count increased after controlling for confounders. Cut point analysis showed a threshold ELN count of 16 in patients with declared node-negative disease, which were examined in the derivation cohorts (SEER 2001 to 2008 HR, 0.830; China HR, 0.738) and validated in the SEER 2009 cohort (HR, 0.837). Conclusion A greater number of ELNs is associated with more-accurate node staging and better long-term survival of resected NSCLC. We recommend 16 ELNs as the cut point for evaluating the quality of LN examination or prognostic stratification postoperatively for patients with declared node-negative disease. (C) 2016 by American Society of Clinical Oncology.
DOI	10.1200/JCO.2016.67.5140
语种	英语
资助项目	Science and Technology Planning Project of Guangdong Province, People's Republic of China[2007B031515017] ; Science and Technology Planning Project of Guangdong Province, People's Republic of China[2008A030201024] ; Science and Technology Planning Project of Guangzhou, People's Republic of China[2007Z1-E0111] ; Science and Technology Planning Project of Guangzhou, People's Republic of China[2007Z3-E0261] ; Guangzhou Health and Medical Collaborative Innovative Major Special Projects[201400000001-2] ; Guangdong Doctoral Launching Program[2014A030310460] ; Doctoral Launching Program of Guangzhou Medical University[2014C27] ; Chinese National Natural Science Foundation[81501996]
WOS研究方向	Oncology
WOS类目	Oncology
WOS记录号	WOS:000398351600006
出版者	AMER SOC CLINICAL ONCOLOGY
引用统计
文献类型	期刊论文
条目标识符	http://ir.amss.ac.cn/handle/2S8OKBNM/24971
专题	系统科学研究所
通讯作者	He, Jianxing
作者单位	1.Guangzhou Med Univ, Affiliated Hosp 1, Guangzhou, Guangdong, Peoples R China 2.Guangzhou Inst Resp Dis, Guangzhou, Guangdong, Peoples R China 3.China State Key Lab Resp Disease, Guangzhou, Guangdong, Peoples R China 4.Sun Yat Sen Univ, Ctr Canc, Guangzhou, Guangdong, Peoples R China 5.Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou, Guangdong, Peoples R China 6.Wenzhou Med Univ, Taizhou Hosp Zhejiang Prov, Linhai, Peoples R China 7.Fudan Univ, Shanghai Zhongshan Hosp, Shanghai, Peoples R China 8.Tongji Univ, Shanghai Pulm Hosp, Shanghai, Peoples R China 9.Fudan Univ, Shanghai Canc Ctr, Shanghai, Peoples R China 10.Sichuan Univ, West China Hosp, Chengdu, Peoples R China 11.Chinese Acad Med Sci, Canc Inst & Hosp, Beijing, Peoples R China 12.Peking Union Med Coll, Beijing, Peoples R China 13.Natl Canc Ctr, Beijing, Peoples R China 14.China & Japan Friendship Hosp, Beijing, Peoples R China 15.Capital Med Univ, Beijing Xuanwu Hosp, Beijing, Peoples R China 16.Chinese Acad Sci, Acad Math & Syst Sci, Beijing, Peoples R China 17.Shenzhen Peoples Hosp, Shenzhen, Peoples R China 18.Chinese Univ Hong Kong, Hong Kong, Peoples R China 19.Nanjing Med Univ, Nanjing, Peoples R China 20.NanjingMed Univ, Affiliated Hosp 1, Nanjing, Peoples R China 21.Sun Yat Sen Canc Ctr, Taipei, Taiwan 22.Univ Copenhagen Hosp, Rigshosp, Copenhagen, Denmark 23.Ist Nazl Tumori Fondazione G Pascale, Naples, Italy 24.Duke Univ, Med Ctr, Durham, NC USA 25.St James Univ Hosp, Leeds, W Yorkshire, England
推荐引用方式 GB/T 7714	Liang, Wenhua,He, Jiaxi,Shen, Yaxing,et al. Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry[J]. JOURNAL OF CLINICAL ONCOLOGY,2017,35(11):1162-1170.
APA	Liang, Wenhua.,He, Jiaxi.,Shen, Yaxing.,Shen, Jianfei.,He, Qihua.,...&He, Jianxing.(2017).Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry.JOURNAL OF CLINICAL ONCOLOGY,35(11),1162-1170.
MLA	Liang, Wenhua,et al."Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry".JOURNAL OF CLINICAL ONCOLOGY 35.11(2017):1162-1170.