The Prognostic Impact of Log Odds of Positive Lymph Nodes on Survival of Patients With Early-stage Non-small Cell Lung Cancer: A Population Study Based on the Seer Database and a Chinese Cohort

Abstract

Objective The purpose of this study was to investigate the prognostic value of log odds of positive lymph nodes (LODDS) in patients with early-stage non-small cell lung cancer (NSCLC). Methods Four hundred and eighty-seven NSCLC patients with pT2N0M0 who underwent radical resection from June 1999 to September 2009 at Sun Yat-Sen University Cancer Center and 8,702 patients from the Surveillance, Epidemiology, and End Results (SEER) were reviewed. According to the X-tile analysis, the patients were classified into two groups based on their log odds ratio [≤ –1.40 (group LODDS1) and > –1.40 (group LODDS2)]. Cox univariate and multivariate analyses were used to identify the prognostic factors for survival. Result Patients were divided into two groups according to the value of LODDS: ≤ – 1.40 (group LODDS1) and > – 1.40 (group LODDS2). For the development cohort, the 5-year CSS rate for patients was 79.6% and 69.3% in the group LODDS1 and LODDS2, respectively (P = .009). For the validation cohort, the 5-year CSS rate was 85.4% for patients in group LODDS1, compared with 82.5% for those in group LODDS2 (P = .006). In multivariate analysis, LODDS was associated with CSS significantly [hazard ratio (HR), 1.487; 95% confidence intervals (CI), 1.126–1.963] in the development cohort. The HR value of LODDS for CSS was 1.260 (95% CI,1.107–1.434) in the validation cohort. Conclusion LODDS was a strong independent prognostic factor for early-stage NSCLC.