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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, Wenhua1,2,3; He, Jiaxi1,2,3; Shen, Yaxing7; Shen, Jianfei1,2,3,6; He, Qihua1,2,3; Zhang, Jianrong1,2,3; Jiang, Gening8; Wang, Qun7; Liu, Lunxu10; Gao, Shugeng11,12,13; Liu, Deruo14; Wang, Zheng17; Zhu, Zhihua4; Ng, Calvin S. H.18; Liu, Chia-chuan21; Petersen, Rene Horsleben22; Rocco, Gaetano23; D'Amico, Thomas24; Brunelli, Alessandro25; Chen, Haiquan9; Zhi, Xiuyi15; Liu, Bo16; Yang, Yixin16; Chen, Wensen19,20; Zhou, Qian5; He, Jianxing1,2,3
2017-04-10
Source PublicationJOURNAL OF CLINICAL ONCOLOGY
ISSN0732-183X
Volume35Issue:11Pages:1162-1170
AbstractPurpose 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.
DOI10.1200/JCO.2016.67.5140
Language英语
Funding ProjectScience 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 Research AreaOncology
WOS SubjectOncology
WOS IDWOS:000398351600006
PublisherAMER SOC CLINICAL ONCOLOGY
Citation statistics
Document Type期刊论文
Identifierhttp://ir.amss.ac.cn/handle/2S8OKBNM/24971
Collection系统科学研究所
Corresponding AuthorHe, Jianxing
Affiliation1.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
Recommended Citation
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.
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