title: Supraclavicular lymph node incisional biopsies have no influence on the prognosis of advanced non-small cell lung cancer patients: a retrospective study.
abstract: BACKGROUND
  Supraclavicular lymph node (SCLN) biopsies play an important role in diagnosing and staging lung cancer. However, not all patients with SCLN metastasis can have a complete resection. It is still unknown whether SCLN incisional biopsies affect the prognosis of non-small cell lung cancer (NSCLC) patients.
  
  
  METHODS
  Patients who were histologically confirmed to have NSCLC with SCLN metastasis were enrolled in the study from January 2007 to December 2012 at Guangdong Lung Cancer Institute. The primary endpoint was OS, and the secondary endpoints were complications and local recurrence/progression.
  
  
  RESULTS
  Two hundred two consecutive patients who had histologically confirmed NSCLC with SCLN metastasis were identified, 163 with excisional and 39 with incisional biopsies. The median OS was not significantly different between the excisional (10.9 months, 95% CI 8.7-13.2) and incisional biopsy groups (10.1 months, 95% CI 6.3-13.9), P = 0.569. Multivariable analysis showed that an Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2 (HR = 2.75, 95% CI 1.71-4.38, P < 0.001) indicated a worse prognosis. Having an epidermal growth factor receptor (EGFR) mutation (HR = 0.58, 95% CI 0.40-0.84, P = 0.004) and receiving systemic treatment (HR = 0.36, 95% CI 0.25-0.53, P < 0.001) were associated with a favorable OS. Neither the number (multiple vs. single) nor site (bilateral vs. unilateral) of SCLNs was associated with an unfavorable OS, and SCLN size or fixed SCLNs did not affect OS.
  
  
  CONCLUSIONS
  SCLN incisional biopsies did not negatively influence the prognosis of NSCLC patients. It was safe and feasible to partly remove a metastatic SCLN as a last resort in advanced NSCLC.
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Song
authors.initials: S
authors.lastname: Dong
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Department of Thoracic Surgery, The First People's Hospital of Foshan, Foshan, People's Republic of China.
authors.forename: Ning
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Southern Medical University, Guangzhou, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Deng
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Southern Medical University, Guangzhou, People's Republic of China.
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Sun
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Southern Medical University, Guangzhou, People's Republic of China.
authors.forename: Fei-Yu
authors.initials: FY
authors.lastname: Niu
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Jin-Ji
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Wen-Zhao
authors.initials: WZ
authors.lastname: Zhong
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Southern Medical University, Guangzhou, People's Republic of China.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Hong-Hong
authors.initials: HH
authors.lastname: Yan
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Chong-Rui
authors.initials: CR
authors.lastname: Xu
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Southern Medical University, Guangzhou, People's Republic of China.
authors.forename: Qiu-Yi
authors.initials: QY
authors.lastname: Zhang
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Xue-Ning
authors.initials: XN
authors.lastname: Yang
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Ri-Qiang
authors.initials: RQ
authors.lastname: Liao
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Nie
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. syylwu@live.cn.
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wu
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000556:secondary* / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Incisional biopsy; Non-small cell lung cancer; Supraclavicular lymph node