Online citations, reference lists, and bibliographies.
← Back to Search

Lymph Node Involvement And Metastatic Lymph Node Ratio Influence The Survival Of Malignant Pleural Mesothelioma: A French Multicenter Retrospective Study.

I. Hysi, F. Le Pimpec-Barthes, M. Alifano, N. Vénissac, J. Mouroux, J. Régnard, M. Riquet, H. Porte
Published 2014 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
Malignant pleural mesothelioma (MPM) is a rare tumor with disastrous evolution. The prognostic value of nodal involvement is still debated. We analyzed the impact of nodal involvement on overall survival (OS) in patients treated by multimodal therapy including extra pleural pneumonectomy (EPP). We evaluated the role, as a prognostic factor, of the metastatic lymph node ratio (LNR), corresponding to the number of involved nodes out of the total number of removed nodes. In this retrospective multicentric study, we reviewed the data of 99 MPM patients. Information regarding lymph node involvement was assessed from the final pathology reports. N1-N3 patients were pooled as N+ group. The OS, calculated by the Kaplan-Meier method, was compared using the log-rank test. A multivariate Cox proportional hazards model was used to identify independent prognostic factors. For the whole cohort, median OS was 18.3 months and 5-year survival was 17.5%. N+ status reduced significantly the median survival (22.4 months for N0 patients vs 12.7 months for N+ patients, P=0.002). A lower metastatic LNR (≤13%) was associated with a significantly improved median survival (19.9 vs. 11.7 months, P=0.01). OS was not related to the number of involved or total removed lymph nodes. In multivariate analysis, only adjuvant radiotherapy (P=0.001) was identified as an independent positive prognostic factor. Metastatic LNR is a more reliable prognostic factor than the number of involved lymph nodes or the total number of removed nodes. However, it could not be identified as an independent prognostic factor.
This paper references
10.1007/s00268-011-1360-8
Value of the Metastatic Lymph Node Ratio for Predicting the Prognosis of Non-Small-Cell Lung Cancer Patients
C. Wang (2011)
10.1002/cncr.24886
Proposed adjustments to pathologic staging of epithelial malignant pleural mesothelioma based on analysis of 354 cases
W. Richards (2010)
10.1097/SLA.0b013e31815aaadf
The Number of Metastatic Lymph Nodes and the Ratio Between Metastatic and Examined Lymph Nodes Are Independent Prognostic Factors in Esophageal Cancer Regardless of Neoadjuvant Chemoradiation or Lymphadenectomy Extent
C. Mariette (2008)
10.1016/S1470-2045(11)70149-8
Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma: clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study
T. Treasure (2011)
10.1053/j.semtcvs.2009.07.007
Surgical techniques for multimodality treatment of malignant pleural mesothelioma: extrapleural pneumonectomy and pleurectomy/decortication.
A. Wolf (2009)
10.1053/j.semtcvs.2008.11.002
Hyperthermic chemoperfusion for the treatment of malignant pleural mesothelioma.
A. Mujoomdar (2008)
10.1016/j.athoracsur.2012.01.065
Number of lymph nodes and metastatic lymph node ratio are associated with survival in lung cancer.
C. Nwogu (2012)
10.1016/S0022-5223(99)70419-8
Systematic nodal dissection in the intrathoracic staging of patients with non-small cell lung cancer.
A. Graham (1999)
10.1378/CHEST.108.4.895
Malignant pleural mesothelioma. A proposed new staging system.
J. Jett (1995)
10.1016/S1010-7940(02)00273-7
The management of malignant pleural mesothelioma; single centre experience in 10 years.
T. Aziz (2002)
10.1056/NEJMRA050152
Advances in malignant mesothelioma.
B. Robinson (2005)
10.1378/chest.108.4.1122
A proposed new international TNM staging system for malignant pleural mesothelioma from the International Mesothelioma Interest Group.
V. Rusch (1996)
10.1016/j.hlc.2010.11.045
A Systematic Review of Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma
C. Cao (2011)
10.1016/j.athoracsur.2008.04.012
Prevalence and pattern of lymph node metastasis in malignant pleural mesothelioma.
A. Abdel Rahman (2008)
10.1378/CHEST.93.1.159
Prognostic factors in diffuse malignant pleural mesothelioma. A study of 167 patients.
E. Chailleux (1988)
10.1053/SONC.2002.30299
Prognostic factors in mesothelioma.
J. Steele (2005)
10.1016/J.JTCVS.2006.06.044
Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma.
M. D. de Perrot (2007)
10.1164/AJRCCM.153.1.8542156
Black spots concentrate oncogenic asbestos fibers in the parietal pleura. Thoracoscopic and mineralogic study.
C. Boutin (1996)
10.1016/S0022-5223(19)39559-5
Lymph node mapping and curability at various levels of metastasis in resected lung cancer.
T. Naruke (1978)
10.1016/S0022-5223(99)70469-1
Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients.
D. Sugarbaker (1999)
10.1016/J.JTCVS.2005.11.044
The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma.
J. Edwards (2006)
10.1007/s00276-002-0081-y
Lymphatic drainage of the diaphragmatic pleura to the peritracheobronchial lymph nodes
G. Okiemy (2003)
10.1016/j.jtcvs.2008.02.069
The impact of lymph node station on survival in 348 patients with surgically resected malignant pleural mesothelioma: implications for revision of the American Joint Committee on Cancer staging system.
R. Flores (2008)
10.1007/BF01627676
Anatomic basis of lymphatic spread of lung carcinoma to the mediastinum: anatomo-clinical correlations
M. Riquet (2005)



This paper is referenced by
Semantic Scholar Logo Some data provided by SemanticScholar