Prognostic Value of Single Nodal Zone Metastasis in Non-Small-Cell Lung Cancer-A Multi-Institutional Study

Area of Science:

• Oncology
• Thoracic Surgery

Background:

• Mediastinal lymph node involvement is a critical prognostic factor in non-small-cell lung cancer (NSCLC).
• Single-zone nodal involvement in NSCLC may present varied prognostic implications.

Purpose of the Study:

• To investigate if the prognosis of NSCLC with single-zone lymph node involvement differs based on the specific lymph node zone affected.
• To identify distinct survival outcomes associated with different mediastinal lymph node stations in NSCLC.

Main Methods:

• Retrospective analysis of 135 NSCLC patients with single lymph node zone involvement who underwent anatomical resection.
• Statistical comparison of patient prognosis based on the location of lymph node involvement (upper, aorto-pulmonary, subcarinal, lower zones).

Main Results:

• Overall survival (OS) and relapse-free survival (RFS) varied significantly across different lymph node zones (p < 0.01).
• Lower zone involvement was associated with a worse prognosis, while upper and subcarinal zones showed better outcomes.
• Aorto-pulmonary (AP) zone involvement presented intermediate survival rates.

Conclusions:

• The anatomical location of lymph node metastasis is a significant prognostic indicator in NSCLC.
• Understanding nodal zone involvement can refine prognostication and guide personalized treatment strategies for NSCLC patients.
• This finding highlights the importance of precise staging for optimizing patient management and survival outcomes.