Prognostic value of lymph node ratio in non-small-cell lung cancer: a meta-analysis
Abstract Background This meta-analysis aimed to investigate the prognostic value of lymph node ratio in non-small-cell lung cancer. Methods We searched systematically for eligible studies in PubMed, Web of Science, Medline (via Ovid) and Cochrane library through 6 November 2018. The primary outcome...
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| Veröffentlicht in: | Japanese journal of clinical oncology 2020-01, Vol.50 (1), p.44-57 |
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| container_title | Japanese journal of clinical oncology |
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| creator | Zhou, Jian Lin, Zhangyu Lyu, Mengyuan Chen, Nan Liao, Hu Wang, Zihuai Hao, Jianqi Yan, Chunyi Liu, Lunxu |
| description | Abstract
Background
This meta-analysis aimed to investigate the prognostic value of lymph node ratio in non-small-cell lung cancer.
Methods
We searched systematically for eligible studies in PubMed, Web of Science, Medline (via Ovid) and Cochrane library through 6 November 2018. The primary outcome was overall survival. Disease-free survival and cancer-specific survival were considered as secondary outcomes. Hazard ratio with corresponding 95% confidence interval were pooled. Quality assessment of included studies was conducted. Subgroup analyses were performed based on N descriptors, types of tumor resection, types of lymphadenectomy and study areas. Sensitivity analysis and evaluation of publication bias were also performed.
Results
Altogether, 20 cohorts enrolling 76 929 patients were included. Mean Newcastle–Ottawa Scale was 7.65 ± 0.59, indicating the studies’ quality was high. The overall result showed non-small-cell lung cancer patients with lower lymph node ratio was associated with better overall survival (HR: 1.946; 95% CI: 1.746–2.169; P |
| doi_str_mv | 10.1093/jjco/hyz120 |
| format | Article |
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Background
This meta-analysis aimed to investigate the prognostic value of lymph node ratio in non-small-cell lung cancer.
Methods
We searched systematically for eligible studies in PubMed, Web of Science, Medline (via Ovid) and Cochrane library through 6 November 2018. The primary outcome was overall survival. Disease-free survival and cancer-specific survival were considered as secondary outcomes. Hazard ratio with corresponding 95% confidence interval were pooled. Quality assessment of included studies was conducted. Subgroup analyses were performed based on N descriptors, types of tumor resection, types of lymphadenectomy and study areas. Sensitivity analysis and evaluation of publication bias were also performed.
Results
Altogether, 20 cohorts enrolling 76 929 patients were included. Mean Newcastle–Ottawa Scale was 7.65 ± 0.59, indicating the studies’ quality was high. The overall result showed non-small-cell lung cancer patients with lower lymph node ratio was associated with better overall survival (HR: 1.946; 95% CI: 1.746–2.169; P < 0.001), disease-free survival (HR: 2.058; 95% CI: 1.717–2.467; P < 0.001) and cancer-specific survival (HR: 2.149; 95% CI: 1.864–2.477; P < 0.001). Subgroup analysis prompted types of lymphadenectomy and the station of positive lymph node have an important effect on the prognosis. No significant discovery was found in sensitivity analysis.
Conclusion
Patients with lower lymph node ratio was associated with better survival, indicating that lymph node ratio may be a promising prognostic predictor in non-small-cell lung cancer. The type of lymphadenectomy, an adequate examined number and the removed stations should be considered for more accurate prognosis assessment.
Lymph node ratio may predict the prognosis of non-small-cell lung cancer patients. Lymphadenectomy types, total examined number and removed stations should also be considered for prognosis evaluation.</description><identifier>ISSN: 1465-3621</identifier><identifier>EISSN: 1465-3621</identifier><identifier>DOI: 10.1093/jjco/hyz120</identifier><identifier>PMID: 31735973</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lymph Node Excision ; Lymph Node Ratio - methods ; Lymph Nodes - pathology ; Prognosis</subject><ispartof>Japanese journal of clinical oncology, 2020-01, Vol.50 (1), p.44-57</ispartof><rights>The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2019</rights><rights>The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c311t-13ad31927708340840fa60bad1fc53116b07b132a1cf9ccac8e1e0e493d7435c3</citedby><cites>FETCH-LOGICAL-c311t-13ad31927708340840fa60bad1fc53116b07b132a1cf9ccac8e1e0e493d7435c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31735973$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Jian</creatorcontrib><creatorcontrib>Lin, Zhangyu</creatorcontrib><creatorcontrib>Lyu, Mengyuan</creatorcontrib><creatorcontrib>Chen, Nan</creatorcontrib><creatorcontrib>Liao, Hu</creatorcontrib><creatorcontrib>Wang, Zihuai</creatorcontrib><creatorcontrib>Hao, Jianqi</creatorcontrib><creatorcontrib>Yan, Chunyi</creatorcontrib><creatorcontrib>Liu, Lunxu</creatorcontrib><title>Prognostic value of lymph node ratio in non-small-cell lung cancer: a meta-analysis</title><title>Japanese journal of clinical oncology</title><addtitle>Jpn J Clin Oncol</addtitle><description>Abstract
Background
This meta-analysis aimed to investigate the prognostic value of lymph node ratio in non-small-cell lung cancer.
Methods
We searched systematically for eligible studies in PubMed, Web of Science, Medline (via Ovid) and Cochrane library through 6 November 2018. The primary outcome was overall survival. Disease-free survival and cancer-specific survival were considered as secondary outcomes. Hazard ratio with corresponding 95% confidence interval were pooled. Quality assessment of included studies was conducted. Subgroup analyses were performed based on N descriptors, types of tumor resection, types of lymphadenectomy and study areas. Sensitivity analysis and evaluation of publication bias were also performed.
Results
Altogether, 20 cohorts enrolling 76 929 patients were included. Mean Newcastle–Ottawa Scale was 7.65 ± 0.59, indicating the studies’ quality was high. The overall result showed non-small-cell lung cancer patients with lower lymph node ratio was associated with better overall survival (HR: 1.946; 95% CI: 1.746–2.169; P < 0.001), disease-free survival (HR: 2.058; 95% CI: 1.717–2.467; P < 0.001) and cancer-specific survival (HR: 2.149; 95% CI: 1.864–2.477; P < 0.001). Subgroup analysis prompted types of lymphadenectomy and the station of positive lymph node have an important effect on the prognosis. No significant discovery was found in sensitivity analysis.
Conclusion
Patients with lower lymph node ratio was associated with better survival, indicating that lymph node ratio may be a promising prognostic predictor in non-small-cell lung cancer. The type of lymphadenectomy, an adequate examined number and the removed stations should be considered for more accurate prognosis assessment.
Lymph node ratio may predict the prognosis of non-small-cell lung cancer patients. Lymphadenectomy types, total examined number and removed stations should also be considered for prognosis evaluation.</description><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lymph Node Excision</subject><subject>Lymph Node Ratio - methods</subject><subject>Lymph Nodes - pathology</subject><subject>Prognosis</subject><issn>1465-3621</issn><issn>1465-3621</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1Lw0AQQBdRbK2evMueRJDYnWw-vZXiFxQU1HOYbDZtymY37iZC_PWmpIonTzMDj8fwCDkHdgMs5fPtVpj5pv8Cnx2QKQRR6PHIh8M_-4ScOLdljIVJEB-TCYeYh2nMp-T1xZq1Nq6tBP1E1UlqSqr6utlQbQpJLbaVoZUeLu25GpXyhFSKqk6vqUAtpL2lSGvZoocaVe8qd0qOSlROnu3njLzf370tH73V88PTcrHyBAdoPeBYcEj9OGYJD1gSsBIjlmMBpQgHIspZnAP3EUSZCoEikSCZDFJexAEPBZ-Rq9HbWPPRSddmdeV236GWpnOZzyEM_WhwD-j1iAprnLOyzBpb1Wj7DFi2q5jtKmZjxYG-2Iu7vJbFL_uTbQAuR8B0zb-mb3JXe08</recordid><startdate>20200124</startdate><enddate>20200124</enddate><creator>Zhou, Jian</creator><creator>Lin, Zhangyu</creator><creator>Lyu, Mengyuan</creator><creator>Chen, Nan</creator><creator>Liao, Hu</creator><creator>Wang, Zihuai</creator><creator>Hao, Jianqi</creator><creator>Yan, Chunyi</creator><creator>Liu, Lunxu</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200124</creationdate><title>Prognostic value of lymph node ratio in non-small-cell lung cancer: a meta-analysis</title><author>Zhou, Jian ; Lin, Zhangyu ; Lyu, Mengyuan ; Chen, Nan ; Liao, Hu ; Wang, Zihuai ; Hao, Jianqi ; Yan, Chunyi ; Liu, Lunxu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-13ad31927708340840fa60bad1fc53116b07b132a1cf9ccac8e1e0e493d7435c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lymph Node Excision</topic><topic>Lymph Node Ratio - methods</topic><topic>Lymph Nodes - pathology</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Jian</creatorcontrib><creatorcontrib>Lin, Zhangyu</creatorcontrib><creatorcontrib>Lyu, Mengyuan</creatorcontrib><creatorcontrib>Chen, Nan</creatorcontrib><creatorcontrib>Liao, Hu</creatorcontrib><creatorcontrib>Wang, Zihuai</creatorcontrib><creatorcontrib>Hao, Jianqi</creatorcontrib><creatorcontrib>Yan, Chunyi</creatorcontrib><creatorcontrib>Liu, Lunxu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Japanese journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Jian</au><au>Lin, Zhangyu</au><au>Lyu, Mengyuan</au><au>Chen, Nan</au><au>Liao, Hu</au><au>Wang, Zihuai</au><au>Hao, Jianqi</au><au>Yan, Chunyi</au><au>Liu, Lunxu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of lymph node ratio in non-small-cell lung cancer: a meta-analysis</atitle><jtitle>Japanese journal of clinical oncology</jtitle><addtitle>Jpn J Clin Oncol</addtitle><date>2020-01-24</date><risdate>2020</risdate><volume>50</volume><issue>1</issue><spage>44</spage><epage>57</epage><pages>44-57</pages><issn>1465-3621</issn><eissn>1465-3621</eissn><abstract>Abstract
Background
This meta-analysis aimed to investigate the prognostic value of lymph node ratio in non-small-cell lung cancer.
Methods
We searched systematically for eligible studies in PubMed, Web of Science, Medline (via Ovid) and Cochrane library through 6 November 2018. The primary outcome was overall survival. Disease-free survival and cancer-specific survival were considered as secondary outcomes. Hazard ratio with corresponding 95% confidence interval were pooled. Quality assessment of included studies was conducted. Subgroup analyses were performed based on N descriptors, types of tumor resection, types of lymphadenectomy and study areas. Sensitivity analysis and evaluation of publication bias were also performed.
Results
Altogether, 20 cohorts enrolling 76 929 patients were included. Mean Newcastle–Ottawa Scale was 7.65 ± 0.59, indicating the studies’ quality was high. The overall result showed non-small-cell lung cancer patients with lower lymph node ratio was associated with better overall survival (HR: 1.946; 95% CI: 1.746–2.169; P < 0.001), disease-free survival (HR: 2.058; 95% CI: 1.717–2.467; P < 0.001) and cancer-specific survival (HR: 2.149; 95% CI: 1.864–2.477; P < 0.001). Subgroup analysis prompted types of lymphadenectomy and the station of positive lymph node have an important effect on the prognosis. No significant discovery was found in sensitivity analysis.
Conclusion
Patients with lower lymph node ratio was associated with better survival, indicating that lymph node ratio may be a promising prognostic predictor in non-small-cell lung cancer. The type of lymphadenectomy, an adequate examined number and the removed stations should be considered for more accurate prognosis assessment.
Lymph node ratio may predict the prognosis of non-small-cell lung cancer patients. Lymphadenectomy types, total examined number and removed stations should also be considered for prognosis evaluation.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31735973</pmid><doi>10.1093/jjco/hyz120</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Disease-Free Survival Female Humans Lung Neoplasms - mortality Lung Neoplasms - pathology Lymph Node Excision Lymph Node Ratio - methods Lymph Nodes - pathology Prognosis |
| title | Prognostic value of lymph node ratio in non-small-cell lung cancer: a meta-analysis |
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