Prognostic value of number of negative lymph node in patients with stage II and IIIa non-small cell lung cancer

Shengguang Wang, Bin Zhang, Chenguang Li, Chao Cui, Dongsheng Yue, Bowen Shi, Qiang Zhang, Zhenfa Zhang, Xi Zhang*, Changli Wang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: The definitive validation evidence of the implications of lymph node metastases regarding the survival of Non-Small Cell Lung Cancer (NSCLC) patients is lacking. We aimed to evaluate the prognostic impact of several lymph node metastases-associated risk factors including Number of Negative Lymph Node (NLN) and risk-stratify NSCLC patients into subsets with different prognosis. Method: A total of 482 patients with N1 and N2 NSCLC were included in this study. The prognostic importance of a set of risk factors was examined by univariate and multivariate analysis. The cut-offpoints and 5 years survival rates were calculated to test the best grouping system to stratify the patients with difference outcome. Results: Our analysis indicated that both Ratio of the Metastatic Lymph nodes (RML) and Number of Negative Lymph Node (NLN) were associated with overall survival (OS) and disease free survival (DFS). RML percentage 20% and 55%, and NLN counts 10 and 30 were proved as the optimal cut-offpoints to predict OS by classifying patients into 3 groups, respectively. RML and NLN actually are more powerful in predicting survival outcome for male patients compared to female patients. Stratified survival analyses using combined factors indicated that the 5-year survival rate (5-YSR) is high in RML I + NLN I/III subgroup (5-YSR = 57.1% and 43.3%) and low in RML III + NLN II/III subgroup (5-YSR = 0.0 % each). Conclusions: NLN is a strong prognostic factor for OS and DFS of stage II/IIIa NSCLC patients, and provides a useful classification scheme for NSCLC patients when combined with RML.

Original languageEnglish (US)
Pages (from-to)79387-79396
Number of pages10
Issue number45
StatePublished - 2017


  • NLN
  • Prognostic factor
  • RML

ASJC Scopus subject areas

  • Oncology


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