Assessing the prognostic value of the extent of mediastinal lymph node infiltration in surgically-treated non-small cell lung cancer (NSCLC)
Assessing the prognostic value of the extent of mediastinal lymph node infiltration in surgically-treated non-small cell lung cancer (NSCLC)
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DOI：
10.1016/s0169-5002(00)00133-1
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发表时间：
2000-11-01
期刊：
影响因子：
5.3
通讯作者：
Gotti, G
中科院分区：
文献类型：
--
作者：
Luzzi, L;Paladini, P;Gotti, G
尽管已经有几次尝试将N2患者根据不同的预后分为几个亚组，但对这些患者的正确治疗仍然是一个有争议的问题。即使是最常用的多模式治疗，也不能产生一致的结果。我们研究的目的是评估手术治疗的非小细胞肺癌（NSCLC）纵隔淋巴结浸润程度的预后价值。从1990年1月到1997年12月，682例患者在锡耶纳大学医院胸外科接受了非小细胞肺癌手术，其中87例（12%）涉及纵隔。对淋巴结数量的研究表明，与其他淋巴结相比，其中一个淋巴结的5年生存率更高。Wa使用基于淋巴结浸润百分比的新评判来研究淋巴结站的数量。该百分比由涉及的节点数与移除的节点总数之比获得。结果显示，淋巴结浸润患者的5年生存率较其他患者有所提高，低于50%，差异有统计学意义（P = 0.0001）。从长期生存的角度来看，手术可能是治疗那些我们认为处于“早期N2期”的N2患者最合适的选择。虽然像纵隔镜这样的侵入性技术似乎是选择N2患者的合适指标，但它不允许先验地计算比例。(C) 2000爱思唯尔科学爱尔兰有限公司版权所有。
Although there have been several attempts in dividing N2 patients into several subgroups on the basis of different prognoses, the correct treatment for these patients is still a moot point. Even multimodal treatment, which is the most common therapy used, does not result in a consistent outcome. The aim of our study is to assess the prognostic value of the extent of mediastinal lymph node infiltration in surgically treated non-small cell lung cancer (NSCLC). From January 1990 to December 1997, 682 patients underwent surgery for NSCLC at the Thoracic Surgery Unit, University Hospital of Siena, 87 of which (12%) had mediastinal involvement. Studies on the number of lymph node stations show that those with one station involved tend to have a better 5-year survival rate with respect to the others. Wa studied the number of lymph node stations by using a new critique based on the percentage of lymph node infiltration. The percentage is obtained from a ratio of the number of involved nodes to the total number of nodes removed. The result was an improved 5-year survival ratio in patients with lymph node infiltration, lower than 50% with respect to the others, and the difference was significant (P = 0.0001). It appears that surgery may be the most suitable option for treating those N2 patients that we consider to be in 'early N2 phase', in view of long term survival. Although an invasive technique like mediastinoscopy seems to be the appropriate indicator in selecting N2 patients, it does not allow the calculation of the ratio a priori. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.