Clinical Research Papers:

Prognostic value of number of negative lymph node in patients with stage II and IIIa non-small cell lung cancer

Shengguang Wang, Bin Zhang, Chenguang Li, Chao Cui, Dongsheng Yue, Bowen Shi, Qiang Zhang, Zhenfa Zhang, Xi Zhang _ and Changli Wang

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Oncotarget. 2017; 8:79387-79396. https://doi.org/10.18632/oncotarget.18154

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Shengguang Wang1,2,3,4, Bin Zhang1,2,3,4, Chenguang Li1,2,3,4, Chao Cui5,6, Dongsheng Yue1,2,3,4, Bowen Shi1,2,3,4, Qiang Zhang1,2,3,4, Zhenfa Zhang1,2,3,4, Xi Zhang7, 8, Changli Wang1,2,3,4

1 Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China

2 Tianjin Lung Cancer Center, Tianjin, 300060, China

3 Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China

4 National Clinical Research Center for Cancer, Tianjin, 300060, China

5 Graduate School, Tianjin Medical University, Tianjin, 300070, China

6 Department of Thoracic Surgery, Tianjin Haihe Hospital, Tianjin, 300350, China

7 Affiliated Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China

8 School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China

Correspondence to:

Xi Zhang, email:

Changli Wang, email:

Keywords: NLN; RML; NSCLC; prognostic factor

Received: January 05, 2017 Accepted: May 06, 2017 Published: May 24, 2017


Background: The definitive validation evidence of the implications of lymph node metastases regarding the survival of Non-Small Cell Lung Cancer (NSCLC) patients is lacking. We aimed to evaluate the prognostic impact of several lymph node metastases-associated risk factors including Number of Negative Lymph Node (NLN) and risk-stratify NSCLC patients into subsets with different prognosis.

Method: A total of 482 patients with N1 and N2 NSCLC were included in this study. The prognostic importance of a set of risk factors was examined by univariate and multivariate analysis. The cut-off points and 5 years survival rates were calculated to test the best grouping system to stratify the patients with difference outcome.

Results: Our analysis indicated that both Ratio of the Metastatic Lymph nodes (RML) and Number of Negative Lymph Node (NLN) were associated with overall survival (OS) and disease free survival (DFS). RML percentage 20% and 55%, and NLN counts 10 and 30 were proved as the optimal cut-off points to predict OS by classifying patients into 3 groups, respectively. RML and NLN actually are more powerful in predicting survival outcome for male patients compared to female patients. Stratified survival analyses using combined factors indicated that the 5-year survival rate (5-YSR) is high in RML I + NLN I/III subgroup (5-YSR = 57.1% and 43.3%) and low in RML III + NLN II/III subgroup (5-YSR = 0.0 % each).

Conclusions: NLN is a strong prognostic factor for OS and DFS of stage II/IIIa NSCLC patients, and provides a useful classification scheme for NSCLC patients when combined with RML.

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