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Metastatic potential of T1a and T1b non-small cell lung cancer: analysis in the Czech population

Czech version

Authors: L. Tulinský 1,2;  M. Kepičová 1,2;  M. Mitták 1,2;  L. Martínek 1,2
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice Ostrava, Česká republika 1;  Katedra chirurgických studií, Lékařská fakulta, Ostravská univerzita, Ostrava, Česká republika, Souhrn 2
Published in: Rozhl. Chir., 2023, roč. 102, č. 6, s. 244-250.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2023.102.6.244–250

Overview

Introduction: Lung cancer is the most common cause of cancer death in the Czech Republic, in part due to its significant metastatic potential. The aim of this study was to collect real data on the metastatic potential and clinical characteristics of T1a and T1b lung cancer in the Czech population and to investigate potential factors that would predict an increased risk of lymph node metastasis.

Methods: Prospective-retrospective study conducted at the Department of Surgery of the University Hospital Ostrava during the period from January 1, 2015, to July 31, 2022. The study included patients who underwent lobectomy or bilobectomy for T1a and T1b non-small cell lung carcinoma. Results: Out of a total of 165 patients with T1a and T1b lung carcinoma, 17.6% of patients were confirmed to have metastatic involvement of the lymph nodes (with 9.1% classified as N2 lymph node involvement). The highest percentage of positive lymph nodes was observed in patients with tumors located in the upper left lobe (29.5%) and lower right lobe (23.3%). Adenocarcinoma was the most commonly metastasizing carcinoma, with 21.1% of patients showing positive lymph nodes. Neuroendocrine carcinoma metastasized in 19.4% of cases, while squamous cell carcinoma did so in 6.8% of cases. The cumulative risk of having positive lymph nodes in T1a and T1b adenocarcinoma located in the upper left lobe reached 40.0%, of which the risk of N2 lymph node involvement was 25.0%.

Conclusion: T1a/b non-small cell lung cancer exhibits significantly lower metastatic potential than T1c tumors and higher. Adenocarcinoma showed a 3-fold higher metastatic potential than squamous cell carcinoma, indicating the need for increased attention in the treatment of lung adenocarcinoma, especially in tumors localized in the upper left lobe, where a cumulative risk of lymph node metastasis of up to 40% was observed.

Keywords:

lung cancer – metastatic potential – T1a – T1b – lymph node involvement

Sources
  1. Global Cancer Observatory. Global Cancer Observatory [online]. Iarc.fr. 2020. [cit.28. 6. 2023]. Available from: https://gco. iarc.fr/.
  2. Rami-Porta R, Ball D, Crowley J, et al. The IASLC lung cancer staging project: Proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2007;2(7):593–602. doi:10.1097/JTO.0b013e31807a2f81.
  3. Detterbeck FC, Boffa DJ, Kim AW, et al. The eighth edition lung cancer stage classification. Chest 2017;151(1):193–203.
  4. Winckelmans T, Decaluwé H, De Leyn P, et al. Segmentectomy or lobectomy for early-stage non-small-cell lung cancer: a systematic review and meta-analysis. Eur J Cardiothorac Surg. 2020;57(6):1051–60.  doi:10.1093/ejcts/ezz339.
  5. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet 2022;399(10335):1607–17. doi:10.1016/ S0140-6736(21)02333-3.
  6. Chen B, Wang X, Yu X, et al. Lymph node metastasis in Chinese patients with clinical T1 non-small cell lung cancer: A multicenter real-world observational study. Thoracic Cancer 2019;10(3):533–42. doi:10.1111/1759-7714.12970.
  7. Seely AJE, Ivanovic J, Threader J, et al. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg. 2010;90(3):936–42. doi:10.1016/j.athoracsur.2010.05.014.
  8. Okada M, Sakamoto T, Nishio W, et al. Characteristics and prognosis of patients after resection of nonsmall cell lung carcinoma measuring 2 cm or less in greatest dimension. Cancer 2003;98(3):535–541. doi:10.1002/cncr.11530.
  9. Fernando HC, Santos RS, Benfield JR, et al. Lobar and sublobar resection with and without brachytherapy for small stage IA non–small cell lung cancer. J Thorac Cardiovasc Surg. 2005;129(2):261–267. doi:10.1016/j.jtcvs.2004.09.025.
  10. Carr SR, Schuchert MJ, Pennathur A, et al. Impact of tumor size on outcomes after anatomic lung resection for stage 1A non–small cell lung cancer based on the current staging system. J Thorac Cardiovasc Surg. 2012;143(2):390–397. 10.1016/j.jtcvs.2011.10.023
  11. D‘Cunha J, Herndon J, Herzan D, et al. Poor correspondence between clinical and pathologic staging in stage 1 nonsmall cell lung cancer: Results from CALGB 9761, a prospective trial. Lung Cancer 2005;48(2):241–246. doi:10.1016/j.lungcan.2004.11.006.
  12. Veeramachaneni N, Battafarano R, Meyers B, et al. Risk factors for occult nodal metastasis in clinical T1N0 lung cancer: A negative impact on survival. Eur J Cardio-Thorac Surg. 2008;33(3):466–469. doi:10.1016/j.ejcts.2007.12.015.
  13. Cho S, Song I, Yang H, et al. Predictive factors for node metastasis in patients with clinical stage I non-small cell lung cancer. Ann Thorac Surg. 2013;96(1):239–245. doi:10.1016/j.athoracsur.2013.03.050.
  14. Chen B, Wang X, Yu X, et al. Lymph node metastasis in Chinese patients with clinical T1 non-small cell lung cancer: A multicenter real-world observational study. Thoracic Cancer 2019;10(3):533–542. doi: 10.1111/1759-7714.12970.
  15. Koike T, Koike T, Yamato Y, et al. Predictive risk factors for mediastinal lymph node metastasis in clinical stage IA non-smallcell lung cancer patients. J Thorac Oncol. 2012;7(8):1246–1251. doi:10.1097/ JTO.0b013e31825871de.
  16. Zhang Y, Sun Y, Shen L, et al. Predictive factors of lymph node status in small peripheral non-small cell lung cancers: Tumor histology is more reliable. Ann Surg Oncol. 2013;20(6):1949–1954. doi:10.1245/s10434-012-2829-x.
  17. Zhang Y, Sun Y, Xiang J, et al. A prediction model for N2 disease in T1 non-small cell lung cancer. J Thorac Cardiovasc Surg. 2012;144(6):1360–1364. doi:10.1016/j. jtcvs.2012.06.050.
  18. Lu T, Yang X, Huang Y, et al. Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades. Cancer Manag Res. 2019;11:943– 953. doi:10.2147/CMAR.S187317.
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