Lymph node sampling and survival in non-small-cell lung cancer: a 10-year Danish cohort study†.

IF 3 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

European Journal of Cardio-Thoracic Surgery Pub Date : 2025-05-06 DOI:10.1093/ejcts/ezaf158

Logi B Arnarsson, Michael Stenger

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引用次数: 0

Abstract

Objectives: To investigate patterns of lymph node sampling and the potential impact on overall survival regarding adherence to selected intraoperative lymph node sampling guidelines. Additionally, we aimed to identify variables associated with guideline adherence and nodal upstaging.

Methods: A retrospective cohort study was conducted of patients undergoing anatomical lung resection for non-small cell lung cancer (clinical T1-4, N0 disease) from 2012 to 2021 identified through the Danish Lung Cancer Registry. Intraoperative lymph node sampling guidelines according to The National Comprehensive Cancer Network (NCCN) were selected. Missing data were imputed and propensity-score-matched by guideline adherence. Survival outcomes were analysed using Kaplan-Meier curves and log-rank test. Logistic and Cox regression assessed factors associated with survival, guideline adherence and nodal upstaging.

Results: A total of 6615 patients were included, 5670 remained after propensity-score-matched. Adherence to the NCCN guidelines did not impact overall survival (log-rank P-value = 0.31) or nodal upstaging (P-value = 0.26). No patient or tumour characteristics were significantly associated with guideline compliance. Factors associated with higher likelihood of upstaging included higher clinical T stage, histopathology, younger age, open surgery and type of resection.

Conclusions: In this cohort, intraoperative lymph node sampling in adherence with the selected NCCN guidelines did not impact survival or nodal upstaging rates.

查看原文本刊更多论文

非小细胞肺癌的淋巴结取样和生存率：一项10年丹麦队列研究。

目的：研究淋巴结取样的模式和对手术中淋巴结取样指南的遵守对总生存率的潜在影响。此外，我们旨在确定与指南依从性和淋巴结占优相关的变量。方法：通过丹麦肺癌登记处（Danish lung cancer Registry），对2012-2021年因非小细胞肺癌（临床T1-4， no疾病）接受解剖肺切除术的患者进行回顾性队列研究。根据国家综合癌症网络（NCCN）选择术中淋巴结取样指南。通过指南依从性计算缺失数据并进行倾向-得分匹配（PSM）。生存结局采用Kaplan-Meier曲线和log-rank检验分析。Logistic和Cox回归评估了与生存、指南依从性和淋巴结占优相关的因素。结果：共纳入6615例患者，其中5670例患者在PSM后仍然存在。遵守NCCN指南并不影响总生存期（log-rank p-value = 0.31）或淋巴结提前期（p-value = 0.26）。没有患者或肿瘤特征与指南依从性显著相关。与较高的占上风可能性相关的因素包括较高的临床t期、组织病理学、年轻、开放手术和切除类型。结论：在本队列中，术中淋巴结取样遵循选定的NCCN指南，不影响生存率或淋巴结分期率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Cardio-Thoracic Surgery 医学-呼吸系统

CiteScore

5.60

自引率

11.80%

发文量

564

审稿时长

2 months

期刊介绍： The primary aim of the European Journal of Cardio-Thoracic Surgery is to provide a medium for the publication of high-quality original scientific reports documenting progress in cardiac and thoracic surgery. The journal publishes reports of significant clinical and experimental advances related to surgery of the heart, the great vessels and the chest. The European Journal of Cardio-Thoracic Surgery is an international journal and accepts submissions from all regions. The journal is supported by a number of leading European societies.