Prognostic Impact of Node-Spreading Pattern in Surgically Treated Small-Cell Lung Cancer: A Multicentric Analysis

Giovanni Leuzzi, Filippo Lococo, Gabriele Alessandrini, Isabella Sperduti, Lorenzo Spaggiari, Federico Venuta, Erino A. Rendina, Pierluigi Granone, Cristian Rapicetta, Piero Zannini, Gaetano Di Rienzo, Maurizio Nicolosi, Francesco Facciolo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

4 Citazioni (Scopus)


Objective: Although surgery in selected small-cell lung cancer (SCLC) patients has been proposed as a part of multimodality therapy, so far, the prognostic impact of node-spreading pattern has not been fully elucidated. To investigate this issue, a retrospective analysis was performed. Methods: From 01/1996 to 12/2012, clinico-pathological, surgical, and oncological features were retrospectively reviewed in a multicentric cohort of 154 surgically treated SCLC patients. A multivariate Cox proportional hazard model was developed using stepwise regression, in order to identify independent outcome predictors. Overall (OS), cancer-specific (CSS), and Relapse-free survival (RFS) were calculated by Kaplan-Meier method. Results: Overall, median OS, CSS, and RFS were 29 (95 % CI 18–39), 48 (95 % CI 19–78), and 22 (95 % CI 17–27) months, respectively. Lymphadenectomy was performed in 140 (90.9 %) patients (median number of harvested nodes: 11.5). Sixty-seven (47.9 %) pN0-cases experienced the best long-term survival (CSS: 71, RFS: 62 months; p < 0.0001). Among node-positive patients, no prognostic differences were found between pN1 and pN2 involvement (CSS: 22 vs. 15, and RFS: 14 vs. 10 months, respectively; p = 0.99). By splitting node-positive SCLC according to concurrent N1-invasion, N0N2-patients showed a worse CSS compared to those cases with combined N1N2-involvement (N0N2: 8 months vs. N1N2: 22 months; p = 0.04). On the other hand, the number of metastatic stations (p = 0.80) and the specific node-level (p = 0.85) did not affect CSS. At multivariate analysis, pN+ (HR: 3.05, 95 % CI 1.21–7.67, p = 0.02) and ratio between metastatic and resected lymph-nodes (RL, HR: 1.02, 95 % CI 1.00–1.04, p = 0.03) were independent predictors of CSS. Moreover, node-positive patients (HR: 3.60, 95 % CI 1.95–6.63, p < 0.0001) with tumor size ≥5 cm (HR: 1.85, 95 % CI 0.88–3.88, p = 0.10) experienced a worse RFS. Conclusions: In selected surgically treated SCLC, the long-term survival may be stratified according to the node-spreading pattern.
Lingua originaleEnglish
pagine (da-a)107-114
Numero di pagine8
Stato di pubblicazionePubblicato - 2017


  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms
  • Lymph Node Excision
  • Lymph Nodes
  • Lymphadenectomy
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multimodality therapy
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Node-spreading pattern
  • Pneumonectomy
  • Radiotherapy, Adjuvant
  • Ratio
  • Retrospective Studies
  • Small-cell lung cancer
  • Surgery
  • Survival Rate
  • Tumor Burden


Entra nei temi di ricerca di 'Prognostic Impact of Node-Spreading Pattern in Surgically Treated Small-Cell Lung Cancer: A Multicentric Analysis'. Insieme formano una fingerprint unica.

Cita questo