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Young age increases risk for lymph node positivity but decreases risk for non-small cell lung cancer death

Authors Xia W, Wang A, Jin M, Mao Q, Xia W, Dong G, Chen B, Ma W, Xu L, Jiang F

Received 19 September 2017

Accepted for publication 8 December 2017

Published 8 January 2018 Volume 2018:10 Pages 41—48

DOI https://doi.org/10.2147/CMAR.S152017

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Nakshatri


Wenjie Xia,1,2,* Anpeng Wang,1,2,* Meng Jin,3,* Qixing Mao,1,2 Wenying Xia,4 Gaochao Dong,1 Bing Chen,1,2 Weidong Ma,1,2 Lin Xu,1 Feng Jiang1

1Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Cancer Hospital, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, 2Department of Oncology, Fourth Clinical College of Nanjing Medical University, Nanjing, 3Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 4Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China

*These authors contributed equally to this work

Abstract:
Non-small cell lung cancer (NSCLC) prognosis and risk of lymph node positivity (LN+) are reference points for reasonable treatments. The aim of the current study was to investigate the effect of age on LN+ and NSCLC death. Data from the Surveillance, Epidemiology, and End Results (SEER) registry were used to identify 82,253 patients with NSCLC diagnosed between 1988 and 2008. All the patients underwent standard lung cancer surgery with lymph node examination. Demographic and clinicopathological parameters were extracted and compared among each age group. Impact of age on LN+ and NSCLC death was evaluated by the Cochran–Armitage trend test and logistic univariate and multivariate analyses for all T stages. Overall, 22,711 (27.60%) patients of the entirety had lymph node metastasis and 28,968 (35.22%) patients died of NSCLC within 5 years. With the increase in age, LN+ rates decreased regardless of T stages (P<0.001), whereas NSCLC-specific mortality increased in stages T1–T3 (P<0.001). Controlling other covariates in multivariable logistic regression, age remained an independent risk factor for LN+ in all T stages (P<0.05) and in stages T1–T3 (P<0.05). Our SEER analysis demonstrated a higher rate of LN+ and lower mortality in younger patients with NSCLC, after accounting for other covariates.

Keywords: NSCLC, lymph node positivity, mortality, age, SEER

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