Original Article
Detection of occult tumor cells in regional lymph nodes is associated with poor survival in pN0 non-small cell lung cancer: a meta-analysis
Abstract
Background: patients of pN0 non-small cell lung cancer (NSCLC) with occult tumor cells (OTCs) in regional lymph nodes (LNs) are reported to have controversial prognostic outcomes.
Method: We pooled pN0 NSCLC patients with OTCs in LNs and compared with those without OTCs. Patient characteristics, hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and/or disease-free survival (DFS) were analyzed. HR greater than 1 conferred an increased hazard for patients with OTCs.
Results: Eighteen articles were finally enrolled in the meta-analysis and 15 studies provided sufficient data for extracting HRs for OS, resulting to 5 articles available for DFS analysis. The combined HRs of OS was 2.22 (95% CI, 1.87 to 2.64) and 2.4 (95% CI, 1.71 to 3.36) for analysis of DFS. The similar trend was obtained in the subgroup analyses regarding detection methods and study type. Interestingly, even in the analysis of mean numbers of LNs dissection (MLND) intraoperatively, both subgroups (LNs/Pts. <12 and ≥12) illustrated significant HRs of OS (HR: 3.13, 95% CI, 2.17 to 4.52 in LNs/Pts. <12 subgroup and HR: 2.09, 95% CI, 1.63 to 2.68 in LNs/Pts. ≥12). The combined HR of OS in this section was 2.37 (95% CI, 1.63 to 2.68). No publication bias was detected in all the meta-analysis sections. The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND.
Conclusions: The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND.
Method: We pooled pN0 NSCLC patients with OTCs in LNs and compared with those without OTCs. Patient characteristics, hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and/or disease-free survival (DFS) were analyzed. HR greater than 1 conferred an increased hazard for patients with OTCs.
Results: Eighteen articles were finally enrolled in the meta-analysis and 15 studies provided sufficient data for extracting HRs for OS, resulting to 5 articles available for DFS analysis. The combined HRs of OS was 2.22 (95% CI, 1.87 to 2.64) and 2.4 (95% CI, 1.71 to 3.36) for analysis of DFS. The similar trend was obtained in the subgroup analyses regarding detection methods and study type. Interestingly, even in the analysis of mean numbers of LNs dissection (MLND) intraoperatively, both subgroups (LNs/Pts. <12 and ≥12) illustrated significant HRs of OS (HR: 3.13, 95% CI, 2.17 to 4.52 in LNs/Pts. <12 subgroup and HR: 2.09, 95% CI, 1.63 to 2.68 in LNs/Pts. ≥12). The combined HR of OS in this section was 2.37 (95% CI, 1.63 to 2.68). No publication bias was detected in all the meta-analysis sections. The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND.
Conclusions: The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND.
