title: Lymph node micrometastases are associated with disease recurrence and poor survival for early-stage non-small cell lung cancer patients: a meta-analysis.
abstract: BACKGROUND
  We performed a meta-analysis to clarify whether the molecular detection of tumor cells or micrometastases in the lymph node (LN) indicates a high risk of disease recurrence and poor survival in negative pathologic lymph node status non-small cell lung cancer (NSCLC).
  
  
  METHODS
  A literature search was performed using relevant keywords. We searched relevant studies from PubMed, Embase, and the Cochrane Library. Direct and indirect meta-estimates were generated using Review Manager software with fixed effects for the study. Study-to-study heterogeneity was summarized using I (2) statistics and predictive intervals (PIs).
  
  
  RESULTS
  Our analysis of eight eligible studies revealed that patients with lymph node micrometastases (LNMM) were associated with poor overall survival (OS) (HR, 1.98; 95 % CI, 1.50 to 2.62; p < 0.00001) and disease-free survival (DFS) (HR, 2.34; 95 % CI, 1.67-3.27; p < 0.00001).
  
  
  CONCLUSIONS
  LNMM is associated with an increased risk of disease recurrence and poor survival in patients with negative pathologic node negative NSCLC. Thus, these patients need to be carefully followed up after the initial pulmonary resection.
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Xu Feng
authors.initials: XF
authors.lastname: Deng
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Quan Xing
authors.initials: QX
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Hou
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Kefan
authors.initials: K
authors.lastname: Cui
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Jia Xin
authors.initials: JX
authors.lastname: Min
authors.affiliation: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China. 691057831@qq.com.
authors.forename: Ji Gang
authors.initials: JG
authors.lastname: Dai
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008207:Lymphatic Metastasis; D061206:Neoplasm Micrometastasis / Q000175:diagnosis*; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis