The Prognostic Value Of Lymph Node Ratio In Patients With N2 Stage Lung Squamous Cell Carcinoma: A Nomogram And Heat
Guoshu Bi1, Tao Lu1, Guangyu Yao1
1Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, People's Republic of China.
Cancer Management and Research
|December 7, 2019
Summary
A lymph node ratio (LNR) below 0.42 indicates better survival for lung squamous cell carcinoma patients with N2 stage disease. This finding offers a new prognostic marker for improved patient outcomes.
Area of Science:
- Thoracic oncology
- Cancer prognostics
- Surgical oncology
Background:
- Lymph node ratio (LNR) is a known survival predictor in various cancers.
- The prognostic significance of LNR in resected N2 stage lung squamous cell carcinoma remains unexamined.
Purpose of the Study:
- To evaluate the prognostic value of LNR in patients with resected N2 stage lung squamous cell carcinoma.
- To develop and validate a predictive model for overall survival (OS) and cancer-specific survival (CSS).
Main Methods:
- Utilized SEER database (1778 patients) and Zhongshan Hospital cohort (146 patients) for validation.
- Identified optimal LNR cutoff using X-tile analysis.
- Constructed a multivariable Cox model and nomogram for survival prediction.
Main Results:
- An LNR cutoff of 0.42 was identified.
- Age, sex, tumor laterality, surgery type, T stage, chemotherapy, and LNR independently predicted OS.
- The nomogram achieved a higher C-index (0.64) than the T stage-based model (0.54).
Conclusions:
- An LNR < 0.42 is associated with improved OS and CSS in resected N2 stage lung squamous cell carcinoma.
- The developed nomogram demonstrates good predictive accuracy and robustness.
