淋巴结清扫数目对无淋巴结转移非小细胞肺癌患者预后的影响

  目的   探讨淋巴结清扫数目对无淋巴结转移非小细胞肺癌患者预后的影响。   方法   回顾性分析305例无淋巴结转移非小细胞肺癌患者临床病理资料。   结果   全组患者中位生存期和5年生存率分别为60.0个月和47.1%。T分期、淋巴结清扫数目和清扫站数是影响本组患者预后的独立预后因素。相同T分期患者生存率随淋巴结清扫数目增加而增高（P < 0.05）。T₁~T₂的患者中，清扫0~11枚淋巴结的患者比清扫更多数目的各组患者预后差（P <0.05）。T₃的患者中，清扫0~16枚淋巴结的患者比清扫更多数目的患者预后差（P <0.05）。淋巴结清扫数目与术后并发症发生率无显著相关性（P>0.05）。   结论   淋巴结清扫数目是无淋巴结转移非小细胞肺癌患者预后的独立预后因素。术中应清扫足够数目的淋巴结，进而提高患者生存率。 

Prognostic value of the number of negative lymph nodes in non-small cell lung cancer without lymphatic metastasis after pulmonary resection

  Objective   This study aims to investigate the correlation between the number of resected lymph nodes (LNs) and the prognosis of patients with node-negative non-small cell lung cancer (NSCLC).   Methods   A retrospective review of 305 patients with NSCLC, who received curative resection between January 2004 and December 2009, was conducted. All patients were proved without lymph node involvement histopathologically. The prognostic impact of the number of negative LNs and the clinicopathologic factors were analyzed.   Results   The overall median survival time and the 1-, 3-, and 5-year overall survival rates were 60.0 months, 76.1%, 59.3%, and 47.1%, respectively. Survival analysis confirmed that the number of negative LNs, T staging and the stations of the mediastinal lymph nodes dissected were showed to be independent prognostic factors. Patients with a high number of negative LNs had better overall survival than patients with a low number of negative LNs (P <0.05). The patients with dissected LNs counts of more than 11 for cases with pT_l~2 tumor (P <0.05) and more than 16 for cases with pT₃ tumor (P <0.05) had better long-term survival outcomes. The post-operative complication rate was 12.1%, which was not significantly correlated with the number of dissected lymph nodes (P>0.05).   Conclusion   The number of negative lymph nodes is an independent prognostic predicting factor for node-negative NSCLC. Sufficient dissection of LNs is recommended to improve the survival of the patients with node-negative NSCLC.