The relationship between pure solid non-small cell lung cancer with diameter less than 2 centimeter and lymph node metastasis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TENG Xiao ¹ , LIU Chengwu ¹ , LIAO Hu ¹ , GUO Chenglin ¹ , LI Weimin ² ,  LIU Lunxu ¹

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Non-small cell lung cancer; lymph node metastasis; pure solid small-sized tumor

DOI：

10.7507/1007-4848.201701022

Video：

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Objective To explore the relationship between pure solid non-small cell lung cancer with diameter<2 cm and lymph node metastasis rate. Methods We retrospectively analyzed clinicopathological data of 611 patients who underwent lobectomy and systematic lymph node dissection in our hospital between October 2005 and September 2016. There were 322 males and 289 females aged 58.8±10.0 years (range from 25 to 84 years). The relationship between clinicopathological feature and lymph node metastasis rate was analyzed by logistic regression. Results Lymph node metastasis was observed in 136 patients. The rate of lymph node metastasis was 22.3% in pure solid non-small cell lung cancer with diameter<2 cm. The result of univariate analysis showed that differentiation of tumor (P<0.001), location of tumor (P=0.047) and gender (P=0.032) were associated with lymph node metastasis. Multivariate analysis showed that differentiation of tumor was an independent risk factor for lymph node metastasis (P<0.001). Conclusion The rate of lymph node metastasis is high in pure solid non-small cell lung cancer with diameter<2 cm. Differentiation of tumor is an independent risk factor for lymph node metastasis. We recommend systematic lymph node dissection in the patients of this group. And we should choose sublobar resection prudentially.

Citation： TENG Xiao, LIU Chengwu, LIAO Hu, GUO Chenglin, LI Weimin, LIU Lunxu. The relationship between pure solid non-small cell lung cancer with diameter less than 2 centimeter and lymph node metastasis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(4): 254-258. doi: 10.7507/1007-4848.201701022 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin, 2016, 66(1): 7-30.
2.	Walter JE, Heuvelmans MA, de Jong PA, et al. Occurrence and lung cancer probability of new solid nodules at incidence screening with low-dose CT: analysis of data from the randomised, controlled NELSON trial. Lancet Oncol, 2016, 17(7): 907-916.
3.	Liang M, Tang W, Xu DM, et al. Low-dose CT screening for lung cancer: computer-aided detection of missed lung cancers. Radiology, 2016, 281(1): 279-288.
4.	Okada M, Nishio W, Sakamoto T, et al. Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection. J Thorac Cardiovasc Surg, 2005, 129(1): 87-93.
5.	Koike T, Terashima M, Takizawa T, et al. Clinical analysis of small-sized peripheral lung cancer. J Thorac Cardiovasc Surg, 1998, 115(5): 1015-1020.
6.	Zhu WY, Tan LL, Wang ZY, et al. Clinical characteristics and advantages of primary peripheral micro-sized lung adenocarcinoma over small-sized lung adenocarcinoma. Eur J Cardiothorac Surg, 2016, 49(4): 1095-1102.
7.	National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. Version 4. 2016. Available from: [2016-02-28].
8.	Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol, 2007, 2(8): 706-714.
9.	Asamura H, Chansky K, Crowley J, et al. The International Association for the Study of Lung Cancer Lung Cancer Staging Project. J Thorac Oncol, 2015, 10(12): 1675-1684.
10.	Yang F, Chen H, Xiang J, et al. Relationship between tumor size and disease stage in non-small cell lung cancer. BMC Cancer, 2010, 10: 474.
11.	Suzuki K, Nagai K, Yoshida J, et al. Predictors of lymph node and intrapulmonary metastasis in clinical stage IA non-small cell lung carcinoma. Ann Thorac Surg, 2001, 72(2): 352-356.
12.	Wisnivesky JP, Yankelevitz D, Henschke CI. Stage of lung cancer in relation to its size: part 2. Evidence. Chest, 2005, 127(4): 1136-1139.
13.	Watanabe S, Oda M, Go T, et al. Should mediastinal nodal dissection be routinely undertaken in patients with peripheral small-sized (2 cm or less) lung cancer? Retrospective analysis of 225 patients. Eur J Cardiothorac Surg, 2001, 20(5): 1007-1011.
14.	Moon Y, Sung SW, Moon SW, et al. Risk factors for recurrence after sublobar resection in patients with small (2 cm or less) non-small cell lung cancer presenting as a solid-predominant tumor on chest computed tomography. J Thorac Dis, 2016, 8(8): 2018-2026.
15.	Gulack BC, Jeffrey Yang CF, Speicher PJ, et al. A Risk Score to Assist Selecting Lobectomy Versus Sublobar Resection for Early Stage Non-Small Cell Lung Cancer. Ann Thorac Surg, 2016, 102(6): 1814-1820.
16.	Okada M, Koike T, Higashiyama M, et al. Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg, 2006, 132(4): 769-775.
17.	Howington JA, Blum MG, Chang AC, et al. Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin, 2016, 66(1): 7-30.
2. Walter JE, Heuvelmans MA, de Jong PA, et al. Occurrence and lung cancer probability of new solid nodules at incidence screening with low-dose CT: analysis of data from the randomised, controlled NELSON trial. Lancet Oncol, 2016, 17(7): 907-916.
3. Liang M, Tang W, Xu DM, et al. Low-dose CT screening for lung cancer: computer-aided detection of missed lung cancers. Radiology, 2016, 281(1): 279-288.
4. Okada M, Nishio W, Sakamoto T, et al. Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection. J Thorac Cardiovasc Surg, 2005, 129(1): 87-93.
5. Koike T, Terashima M, Takizawa T, et al. Clinical analysis of small-sized peripheral lung cancer. J Thorac Cardiovasc Surg, 1998, 115(5): 1015-1020.
6. Zhu WY, Tan LL, Wang ZY, et al. Clinical characteristics and advantages of primary peripheral micro-sized lung adenocarcinoma over small-sized lung adenocarcinoma. Eur J Cardiothorac Surg, 2016, 49(4): 1095-1102.
7. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. Version 4. 2016. Available from: [2016-02-28].
8. Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol, 2007, 2(8): 706-714.
9. Asamura H, Chansky K, Crowley J, et al. The International Association for the Study of Lung Cancer Lung Cancer Staging Project. J Thorac Oncol, 2015, 10(12): 1675-1684.
10. Yang F, Chen H, Xiang J, et al. Relationship between tumor size and disease stage in non-small cell lung cancer. BMC Cancer, 2010, 10: 474.
11. Suzuki K, Nagai K, Yoshida J, et al. Predictors of lymph node and intrapulmonary metastasis in clinical stage IA non-small cell lung carcinoma. Ann Thorac Surg, 2001, 72(2): 352-356.
12. Wisnivesky JP, Yankelevitz D, Henschke CI. Stage of lung cancer in relation to its size: part 2. Evidence. Chest, 2005, 127(4): 1136-1139.
13. Watanabe S, Oda M, Go T, et al. Should mediastinal nodal dissection be routinely undertaken in patients with peripheral small-sized (2 cm or less) lung cancer? Retrospective analysis of 225 patients. Eur J Cardiothorac Surg, 2001, 20(5): 1007-1011.
14. Moon Y, Sung SW, Moon SW, et al. Risk factors for recurrence after sublobar resection in patients with small (2 cm or less) non-small cell lung cancer presenting as a solid-predominant tumor on chest computed tomography. J Thorac Dis, 2016, 8(8): 2018-2026.
15. Gulack BC, Jeffrey Yang CF, Speicher PJ, et al. A Risk Score to Assist Selecting Lobectomy Versus Sublobar Resection for Early Stage Non-Small Cell Lung Cancer. Ann Thorac Surg, 2016, 102(6): 1814-1820.
16. Okada M, Koike T, Higashiyama M, et al. Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg, 2006, 132(4): 769-775.
17. Howington JA, Blum MG, Chang AC, et al. Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The relationship between pure solid non-small cell lung cancer with diameter less than 2 centimeter and lymph node metastasis

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