A Study of the Number and Metastatic Status of Lymph Nodes Ressected During Non-Small Cell Lung Cancer Surgery

摘要

OBJECTIVE To analyze the number and the metastatic status of lymph nodes resected during NSCLC surgery, and to determine the relationship of the lymph node status to the prognosis. METHODS Clinical data from 1,575 inpatient NSCLC cases were retrospectively reviewed, and the number and the different metastatic status of the LNs resected analyzed. The Kaplan-Meier method was used for survival analysis. RESULTS Stage NO patients with 7 to 12 LNs resected during surgery had a significant increase in survival (P = 0.001, 0.021),compared to patients with less than 6 LNs or more than 12 LNs. Stage N1 or N2 patients with more than 12 LNs resected had a significant increase in survival(P = 0.000, 0.003), compared with cases who had less than 6 LNs or 7 to 12 LNs re- sected.The 5-year survival rate of Stage NO patients was superior to Stage N1 and N2 patients (P = 0.000,0.000),and the 5-year survival rates of Stage NO and skip N2 patients were superior to the continue N2 patients. Patients with a single station of LNs metastasis had a significant increase in survival (P = 0.000), compared with those with multiple stations of LNs metastasis. Patients with 1 to 2 metastatic LNs had a significant increase in survival (P = 0.000),compared with patients having more than 2 metastatic LNs.The metastatic LN ratio(percentage of metastatic lymph nodes resected) was divided into four subgroups: < 25%, 25%～50%, 51%～75%, >75%. The 5-year survival rate gradually decreased with an increase in the metastatic ratio. CONCLUSION For patients with NSCLC the number of LNs resected during surgery should be 7 to 12; the range and number of LN metastasis and the metastatic LN ratio significantly affect the prognosis of patients with NSCLC.