Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry.
Wenhua Liang,Jiaxi He,Yaxing Shen,Jianfei Shen,Qihua He,Jianrong Zhang,Gening Jiang,Qun Wang,Lunxu Liu,Shugeng Gao,Deruo Liu,Zheng Wang,Zhihua Zhu,Calvin S.H. Ng,Chia-Chuan Liu,René Horsleben Petersen,Gaetano Rocco,Thomas A. D'Amico,Alessandro Brunelli,Haiquan Chen,Xiuyi Zhi,Bo Liu,Yixin Yang,Wensen Chen,Qian Zhou,Jianxing He +25 more
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TLDR
A greater number of ELNs is associated with more-accurate node staging and better long-term survival of resected NSCLC and is recommended as the cut point for evaluating the quality of LN examination or prognostic stratification postoperatively for patients with declared node-negative disease.Abstract:
Purpose We investigated the correlation between the number of examined lymph nodes (ELNs) and correct staging and long-term survival in non-small-cell lung cancer (NSCLC) by using large databases and determined the minimal threshold for the ELN count. Methods Data from a Chinese multi-institutional registry and the US SEER database on stage I to IIIA resected NSCLC (2001 to 2008) were analyzed for the relationship between the ELN count and stage migration and overall survival (OS) by using multivariable models. The series of the mean positive LNs, odds ratios (ORs), and hazard ratios (HRs) were fitted with a LOWESS smoother, and the structural break points were determined by Chow test. The selected cut point was validated with the SEER 2009 cohort. Results Although the distribution of ELN count differed between the Chinese registry (n = 5,706) and the SEER database (n = 38,806; median, 15 versus seven, respectively), both cohorts exhibited significantly proportional increases from N0 to N1 and N2 disease (SEER OR, 1.038; China OR, 1.012; both P < .001) and serial improvements in OS (N0 disease: SEER HR, 0.986; China HR, 0.981; both P < .001; N1 and N2 disease: SEER HR, 0.989; China HR, 0.984; both P < .001) as the ELN count increased after controlling for confounders. Cut point analysis showed a threshold ELN count of 16 in patients with declared node-negative disease, which were examined in the derivation cohorts (SEER 2001 to 2008 HR, 0.830; China HR, 0.738) and validated in the SEER 2009 cohort (HR, 0.837). Conclusion A greater number of ELNs is associated with more-accurate node staging and better long-term survival of resected NSCLC. We recommend 16 ELNs as the cut point for evaluating the quality of LN examination or prognostic stratification postoperatively for patients with declared node-negative disease.read more
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Survival Rates After Lobectomy, Segmentectomy, and Wedge Resection for Non-Small Cell Lung Cancer
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Yuan Zeng,Nicholas R. Mayne,Chi-Fu Jeffrey Yang,Thomas A. D'Amico,Calvin S.H. Ng,Chia-Chuan Liu,René Horsleben Petersen,Gaetano Rocco,Alessandro Brunelli,Jun Liu,Yang Liu,Weizhe Huang,Jiaxi He,Wei Wang,Long Jiang,Fei Cui,Wenjun Wang,Wenhua Liang,Jianxing He +18 more
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TL;DR: The radiomics nomogram, based on preoperative CT images, can be used as a noninvasive method to predict LNM in patients with solid lung adenocarcinoma.
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Histone deacetylase 11 inhibition promotes breast cancer metastasis from lymph nodes
Patrick L. Leslie,Yvonne L. Chao,Yi-Hsuan Tsai,Subrata K. Ghosh,Alessandro Porrello,Amanda E.D. Van Swearingen,Emily B. Harrison,Brian C. Cooley,Joel S. Parker,Lisa A. Carey,Chad V. Pecot +10 more
TL;DR: It is shown that breast cancer patients frequently have LN metastases that closely resemble distant metastases, and a mechanism explaining how HDAC11 plasticity promotes breast cancer growth as well as dissemination from LNs is revealed and caution with the use of HDAC inhibitors is suggested.
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