Prognostic Value of Preoperative N Subcategories in Patients with Stage IIIA N2 Non-Small Cell Lung Cancer

被引：0

作者：

Oh, Na Eun ^{[1
,2
]}

Choe, Jooae ^{[1
,2
]}

Yun, Jae Kwang ^{[3
]}

Ji, Wonjun ^{[4
]}

Kim, Seonok ^{[5
]}

Chae, Eun Jin ^{[1
,2
]}

Lee, Sang Min ^{[1
,2
]}

Seo, Joon Beom ^{[1
,2
]}

机构：

[1] Univ Ulsan, Asan Med Ctr, Dept Radiol, Coll Med, 88 Olymp Ro 43 Gil, Seoul 138736, South Korea

[2] Univ Ulsan, Res Inst Radiol, Coll Med, Asan Med Ctr, 88 Olymp Ro 43 Gil, Seoul 138736, South Korea

[3] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Thorac & Cardiovasc Surg, 88 Olymp Ro 43 Gil, Seoul 138736, South Korea

[4] Univ Ulsan, Asan Med Ctr, Dept Internal Med, Div Pulmonol & Crit Care Med,Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea

[5] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Clin Epidemiol & Biostat, 88 Olymp Ro 43 Gil, Seoul, South Korea

来源：

RADIOLOGY-CARDIOTHORACIC IMAGING | 2024年 / 6卷 / 04期

关键词：

RISK-FACTORS; CHEMOTHERAPY; RESECTION; SURVIVAL; DISEASE; TRIAL;

D O I：

10.1148/ryct.230347

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To evaluate the preoperative risk factors in patients with pathologic IIIA N2 non-small cell lung cancer (NSCLC) who underwent upfront surgery and to evaluate the prognostic value of new N subcategories. Materials and Methods: Patients with pathologic stage IIIA N2 NSCLC who underwent upfront surgery in a single tertiary center from January 2015 to April 2021 were retrospectively reviewed. Each patient's clinical N (cN) was assigned to one of six subcategories (cN0, cN1a, cN1b, cN2a1, cN2a2, and cN2b) based on recently proposed N descriptors. Cox regression analysis was used to identify the significant prognostic factors for recurrence-free survival (RFS) and overall survival (OS). Results: A total of 366 patients (mean age +/- SD, 62.0 years +/- 10.1; 202 male patients [55%]) were analyzed. The recurrence rate was 55% (203 of 366 patients) over a median follow-up of 37.3 months. Multivariable analysis demonstrated that cN (hazard ratios [HRs] for cN1 and cN2b compared with cN0, 1.66 [95% CI: 1.11, 2.48] and 2.11 [95% CI: 1.32, 3.38], respectively) and maximum lymph node (LN) size at N1 station (>= 12 mm; HR, 1.62 [95% CI: 1.15, 2.29]), in addition to clinical T category (HR, 1.51 [95% CI: 1.14, 1.99]), were independent prognostic factors for RFS. For OS, clinical N subcategories (cN1, cN2a2, and cN2b vs cN0; HRs, 1.91 [95% CI: 1.11, 3.27], 1.89 [95% CI: 1.13, 2.18], and 2.02 [95% CI: 1.07, 3.80], respectively) and LN size at N1 station (HR, 1.75 [95% CI: 1.12, 2.71]) were independent prognostic factors. For clinical N1, OS was further stratified according to LN size (log-rank test, P < .001). Conclusion: Assessing the proposed N subcategories by reporting single versus multistation involvement of N2 disease and maximum size of metastatic LN, reflecting metastatic burden, at preoperative CT may offer useful prognostic information for planning optimal treatment strategies.

引用

页数：10