Predictors of lymph node metastasis and possible selective lymph node dissection in clinical stage IA non-small cell lung cancer

• DOI: 10.21037/jtd.2018.06.129
• Publication Date: 2018-07-31T06:07:02Z
• Authors: Ningning Ding; Yousheng Mao; Shugeng Gao; Qi Xue; Dali Wang; Jun Zhao; Yushun Gao; Jinfeng Huang; Kang Shao; Feiyue Feng; Yue Zhao; Ligong Yuan
• Keywords: Ground-glass opacity

The pathologic stages of lymph nodes usually differ from preoperatively predicted in lung cancers and it is difficult to predict the metastasis for patients diagnosed as clinical stage IA non-small cell (NSCLC). This study aimed investigate patterns node risk factors predicting with NSCLCs.All NSCLC July 2013 June 2017 our center were retrospectively reviewed, a total number 1,543 who underwent anatomical lobectomy systematic dissection enrolled this study. Multivariate logistic regression analysis was performed identify metastasis, Fisher's exact test used confirm spread mode according locations primary tumors.Totally, metastases presented 131 (8.5%) series. Sixty-three N1 diseases, 17 showed only skipped N2 51 had simultaneous positive nodes. No found pure ground grass opacity (GGO). When arbitrarily divided into six groups by longest tumor diameter ≤0.5, 0.6-1, 1.1-1.5, 1.6-2.0, 2.1-2.5, 2.6-3 cm, rates each group 0% (0/20), 1.5% (4/264), 4.7% (20/429), 8.6% (29/336), 13.1% (38/290), 19.6% (40/204), respectively. GGO excluded, partial or solid tumors (0/10), 2.4% (4/164), 6.6% (20/303), 11.7% (29/249), 16.0% (38/238) 23.1% (40/173). cut off value receiver operating characteristic (ROC) curve size 1.95 area under (AUC) measured 0.681 (P<0.001, 95% CI: 0.630-0.726). indicated that male [odds ratio (OR) =3.34, P=0.012], smoking history (OR =14.12, P<0.001), components P=0.01), large =1.9, poor differentiation =2.25, P=0.013), lymphovascular invasion =58.45, visceral pleural =48.37, P<0.001) significantly associated NSCLC. rate non-lobe specific 15.8-40.0% when any lobe positive, while 0-2.2% all negative.Tumor size, components, differentiation, invasion, significant Patients negative lobe-specific have very low Lobe-specific may become an alternative NSCLC, especially ≤2 cm.