Does Examined Lymph Node Count Influence Survival in Surgically Resected Early-stage Pulmonary Typical Carcinoid Tumors?

作者全名："Yang, Hao; Liu, Tong; Li, Mengqi; Fang, Zhanglan; Luo, Ling"

作者地址："[Yang, Hao; Fang, Zhanglan; Luo, Ling] Chongqing Univ Canc Hosp, Dept Internal Med, Chongqing Key Lab Translat Res Canc Metastasis &, 181 Hanyu Rd, Chongqing 400030, Peoples R China; [Liu, Tong] Chongqing Bishan Hosp Tradit Chinese Med, Chongqing, Peoples R China; [Li, Mengqi] Chongqing Med Univ, Dept Resp & Crit Care Med, Affiliated Hosp 1, Chongqing, Peoples R China"

通信作者："Luo, L (通讯作者)，Chongqing Univ Canc Hosp, Dept Internal Med, Chongqing Key Lab Translat Res Canc Metastasis &, 181 Hanyu Rd, Chongqing 400030, Peoples R China."

来源：AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000966780900004

JCR分区：Q3

影响因子：2.6

年份：2022

卷号：45

期号：12

开始页：506

结束页：513

文献类型：Article

关键词：pulmonary typical carcinoid; examined lymph nodes; prognosis; propensity score matching analysis; SEER database

摘要："Objectives: We aimed to evaluate the prognostic impact of the number of examined lymph nodes (ELNs) in resected early-stage pulmonary typical carcinoid tumors (TC). Methods: Patients who underwent sublobar resection and lobectomy for stage T1N0M0 TC between 2004 and 2016 were identified from the Surveillance, Epidemiology, and End Results database and enrolled in the ELNs >= 4 or ELNs<4 groups (optimal cutoff using X-tile). Propensity score matching balanced baseline intergroup characteristics. Kaplan-Meier curve and log-rank test were used to calculate and compare overall survival (OS) rates. Cox proportional hazard model analysis was used to identify independent prognostic factors. Results: Among 2234 participants, 961 (43.02%) and 1273 (56.98%) had ELNs <4 and >= 4, respectively. The 5-year OS was significantly higher in the ELNs >= 4, compared with ELNs<4, group, both before and after propensity score matching (95.41% vs. 89.71%, P<0.001 and 95.24% vs. 90.28%, P=0.004), respectively. Surgical subgroup analysis confirmed this survival trend in the lobectomy and sublobar resection groups. Tumor size-based subgroup analysis revealed superior OS with ELNs >= 4 than ELNs<4 for tumors measuring 1.1-3.0 cm but not for tumors <1.0 cm. Multivariate Cox analysis showed that ELN >= 4 contributed to improved OS. Conclusions: The higher the ELNs, the greater the long-term survival rate in patients with early-stage TC. Therefore, we recommend at least 4 ELNs as the cutoff value for evaluating the prognosis of early-stage TCs, especially for patients with a tumor size of 1.1 to 3.0 cm."

基金机构：Natural Science Foundation Project of Chongqing [cstc2020jcyj-msxmX1093]

基金资助正文：This work was supported by Natural Science Foundation Project of Chongqing (No. cstc2020jcyj-msxmX1093).