Predictors and survival impact of station 4L metastasis in left non-small cell lung cancer
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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).
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.
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.
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.
KeywordsNon-small cell lung cancer Station 4L metastasis Lymph-node dissection Prognosis
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.
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.
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 was obtained from all individual participants included in the study.
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