Dataset Information

Impact of examined lymph node count on long-term survival of T1-2N0M0 double primary NSCLC patients after surgery: a SEER study.

ABSTRACT: Purpose:The relationship between examined lymph nodes (ELN) and survival has been confirmed in several single early-stage malignancies. We studied the association between the ELN count and the long-term survival of T1-2N0M0 double primary non-small cell lung cancer (DP-NSCLC) patients after surgery, based on the Surveillance, Epidemiology and End Results (SEER) database. Methods:A total of 948 patients were identified and their independent prognostic factors were analyzed. These factors included the ELN count, which related to overall survival (OS) and the cancer-specific survival (CSS) of synchronous (n = 426) and metachronous (n = 522) T1-2N0M0 DP-NSCLC patients after surgery. Results:X-tile analysis indicated that the cutoff value for the sum of ELNs was 22 for both OS and CSS in the synchronous DP-NSCLC group. Patients with a sum of ELNs >22 were statistically more likely to survive than those with ?22 ELNs. X-tile analysis revealed that the ELN count of the second lesion was related to both OS and CSS in the metachronous DP-NSCLC group. The optimal cutoff value was nine. These results were confirmed using univariate and multivariate Cox regression analyses. Conclusion:Our findings indicate that ELN count was highly correlated with the long-term survival of T1-2N0M0 double primary NSCLC patients after surgery.

SUBMITTER: Jiang K

PROVIDER: S-EPMC7049255 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Impact of examined lymph node count on long-term survival of T1-2N0M0 double primary NSCLC patients after surgery: a SEER study.

Jiang Kan K Zhi Xiaohui X Shen Yue Y Ma Yuanyuan Y Su Xinyu X Zhou Liqing L

PeerJ 20200226

<h4>Purpose</h4>The relationship between examined lymph nodes (ELN) and survival has been confirmed in several single early-stage malignancies. We studied the association between the ELN count and the long-term survival of T1-2N0M0 double primary non-small cell lung cancer (DP-NSCLC) patients after surgery, based on the Surveillance, Epidemiology and End Results (SEER) database.<h4>Methods</h4>A total of 948 patients were identified and their independent prognostic factors were analyzed. These f ...[more]

PMID: 32149032

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Project description:BackgroundSurgical resection could improve the survival of patients with early-stage small cell lung cancer (SCLC). However, there is a lack of dedicated studies concentrating on surgical treatment in older patients with T1-2N0M0 SCLC. Thus, we performed this population-based study to investigate whether older patients with T1-2N0M0 SCLC could benefit from surgery.MethodsWe collected the data of patients with SCLC between 2000 and 2015 from the Surveillance, Epidemiology, and End Results Program database. Older patients (≥ 65 years) with T1-2N0M0 SCLC were included, and we converted the staging information into those of the eighth edition. The propensity score matching (PSM) was used to balance the distribution of clinical characteristics between surgery and no-surgery groups.ResultsBefore PSM, the distribution proportions of clinical characteristics in 1,229 patients were unbalanced. The Kaplan-Meier curves of overall survival (OS) and cancer-specific survival (CSS) showed that the patients in the surgery group were better than those in the non-surgery group (all P < 0.001). After 1:2 PSM, the distribution proportions of clinical characteristics in 683 patients were balanced (all P > 0.05). The OS and CSS of patients in the surgery group were still better than that of patients in the no-surgery group (all P < 0.001), and subgroup analysis showed that the surgery was a protective factor for OS and CSS in all clinical characteristics subgroups (almost P < 0.001). The multivariate Cox analysis further confirmed this result (OS: HR, 0.33; 95% CI, 0.27-0.39; P < 0.001; CSS: HR, 0.29; 95% CI, 0.23-0.36; P < 0.001). The result of subgroup analysis based on age, T stage, and adjuvant therapy showed that surgery was related to better OS and CSS compared with non-surgery group (almost P < 0.001) and that lobectomy exhibited the longer survival than sublobectomy. Age, sex, and race were the independent prognostic factors for OS in patients undergoing surgery, whereas only the factor of age affects the CSS in patients with surgery.ConclusionsOlder patients with T1-2N0M0 SCLC can benefit significantly from surgical treatment, and lobectomy provides better prognosis than sublobectomy.

Project description:BackgroundThere are few methods related to predicting lymph node metastasis (LNM) in patients with clinically staged T1 or T2 colon cancer. In this study, we aimed to discover independent risk factors for patients with pathologic T-stage 1 (pT1) or pT2 colon cancer with LNM and to develop a nomogram for predicting the probability of LNM for patients with clinically staged T1 or T2 colon cancer.MethodsAll data were drawn from the Surveillance, Epidemiology, and End Results (SEER) database. Independent risk factors for LNM were identified using univariate and multivariate logistic regression analyses, and these factors were used to construct a nomogram. The discriminatory power, accuracy, and clinical utility of the model were evaluated using receiver operating characteristic (ROC), calibration, and decision curve analysis (DCA), respectively.ResultsAccording to the inclusion and exclusion criteria, 32,803 patients with stage pT1 or pT2 colon cancer who had undergone surgery were selected from the SEER database. The data showed that the incidence of LNM in patients with pT1 and pT2 colon cancer was 17.11%. The age, histological grade, histological type, T classification, M classification, and tumour location were independent risk factors identified through univariate and multivariate analyses, and these factors were used to construct a nomogram. The ROC curve analysis showed that the area under the curve (AUC) of the ROC of the predictive nomogram for LNM risk was 0.6714 [95% confidence interval (CI): 0.6621-0.6806] in the training set and 0.6567 (95% CI: 0.6422-0.6712) in the validation set, indicative of good discriminatory power of the model. Calibration curve analysis demonstrated good agreement between the nomogram prediction and actual observation. DCA showed excellent clinical utility of the prediction model.ConclusionsThe incidence of LNM was high in patients with pT1 and pT2 colon cancer. The nomogram established in this study can accurately predict the risk of LNM in patients with clinically staged T1 or T2 colon cancer before further clinical intervention, which allows clinicians to develop optimal treatment.

Dataset Information

Impact of examined lymph node count on long-term survival of T1-2N0M0 double primary NSCLC patients after surgery: a SEER study.

Publications

Impact of examined lymph node count on long-term survival of T1-2N0M0 double primary NSCLC patients after surgery: a SEER study.

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