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Predictors and survival impact of station 4L metastasis in left non-small cell lung cancer

  • Likui Fang
  • Luming Wang
  • Yiqing Wang
  • Yihe Wu
  • Peng Ye
  • Wang Lv
  • Jian HuEmail author
Original Article – Clinical Oncology
  • 13 Downloads

Abstract

Background

It remains unclear about the predictors and survival impact of station 4L metastasis in left-sided non-small cell lung cancer (NSCLC). This study aims to investigate these issues to explore the significance of station 4L lymph-node dissection (LND).

Methods

We retrospectively enrolled 405 patients with station 4L LND, and divided them into the positive station 4L metastasis group and the negative station 4L metastasis group. The logistic regression was performed to identify the predictors of station 4L metastasis. The survival outcomes including disease-free survival (DFS) and overall survival (OS) were analyzed in pN2 patients to explore the prognostic effect of station 4L metastasis.

Results

There were 48 (11.9%) patients in the positive station 4L metastasis group and 357 (88.1%) patients in the negative station 4L metastasis group. Station 5 metastasis (P = 0.008, OR 7.578, 95% CI 1.710–33.589), station 10 metastasis (P = 0.004, OR 7.133, 95% CI 1.904–26.717), and cN2 (P = 0.010, OR 5.062, 95% CI 1.473–17.392) were independent risk factors of station 4L metastasis. In pN2 patients, the positive station 4L metastasis group had inferior DFS (P = 0.019) and OS (P = 0.006) compared with the negative station 4L metastasis group, and station 4L metastasis was the independent risk factor for poor prognosis.

Conclusion

It is of great necessity to perform station 4L LND in left NSCLC, because station 4L metastasis is not rare and has an unfavorable prognosis.

Keywords

Non-small cell lung cancer Station 4L metastasis Lymph-node dissection Prognosis 

Notes

Author contributions

Drs. JH and LF contributed to the conception and design of the work. Dr. LF and contributed to conception, design, data analysis, and editing the manuscript. Drs. LF, LW, YW, and YW contributed to data acquisition, statistical analysis, and interpretation of the data. Drs. PY and WL contributed to the revision of the manuscript.

Funding

This study was funded by Major Science and Technology Projects of Zhejiang Province (2014C03032), Key Disciplines of Traditional Chinese Medicine in Zhejiang Province (2017-XK-A33), National Key R&D Program of China (2017YFC0113500), and National Natural Science Foundation of China (31700690). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest regarding the publication of this paper.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Thoracic Surgery, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina

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