期刊
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
卷 60, 期 5, 页码 1212-1220出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/ejcts/ezab287
关键词
Small-cell lung cancer; Lymph node ratio; Propensity score matching analysis; Prognosis; SEER database
The study found that in surgically resected stage I-III small-cell lung cancer patients, LNR <= 0.15 was associated with better survival rates, while LNR > 0.15 was associated with poorer survival rates. The predictive value of LNR should be further validated in prospective studies.
OBJECTIVES: Due to the lack of prospective studies, the role of the lymph node ratio (LNR) in small-cell lung cancer (SCLC) remains unknown. This study aimed to assess the prognostic effect of LNR in surgically resected stage I-III SCLC patients. METHODS: Clinical data of stage I-III (excluding N3 and NX) SCLC patients diagnosed between 1998 and 2016 were extracted from the Surveillance, Epidemiology and End Results database. Patients were divided into low-risk and high-risk subsets based on the LNR cut-off value of 0.15 using X-tile software. Propensity score matching analysis was employed to reduce bias in baseline characteristics. Kaplan-Meier analysis was performed to determine the overall survival (OS) and lung cancer-specific survival (LCSS). Cox regression analysis was performed to evaluate the effects of multiple variables. RESULTS: A total of 978 patients were identified, of whom 669 (68.40%) had LNR <= 0.15. Patients with LNR <= 0.15 showed better OS (P <0.001) and LCSS (P < 0.001) both before and after propensity score matching. Multivariable analyses of the matched population confirmed LNR as an independent prognostic factor. Patients with LNR >0.15 showed poorer OS [hazard ratio (HR) 1.55, 95% confidence interval (CI) 1.09-2.19; P=0.015] and LCSS (HR 1.65, 95% CI 1.13-2.43; P=0.010). Subgroup analyses revealed that LNR <= 0.15 was associated with favourable OS (P=0.009 and 0.197, respectively) and LCSS (P=0.010 and 0.169, respectively) in N1 and N2 patients. CONCLUSIONS: LNR was determined as an independent predictor for surgically resected stage I-Ill SCLC, indicating that higher LNR is associated with reduced survival. The predictive value of LNR should to be further validated in prospective studies.
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