Log odds of positive lymph nodes as a novel prognostic indicator in NSCLC staging.
OBJECTIVE
The paper aimed to compare the efficacy of log odds (LODDS) compared to a classification based on the distribution of involved lymph nodes (pN) and lymph node ratio (LNR).


METHODS
Material was collected retrospectively from an online survey-based database of the Polish Lung Cancer Group and included a group of 17,369 patients who received radical surgical treatment (R0) due to lung cancer.


RESULTS
In the whole group the median survival for N0, N1 and N2 was 76.1, 41.7 and 24.2 months, respectively. The median survival for individual LODDS categories (-6,-4], (-4,-3], (-3,-2], (-2,-1], (-1,0], (0,1] and (1,2] was 76.5, 76.3, 71.7, 45.4, 25.0, 19.1 and 17.7 months, respectively. The median survival for LNR in individual categories (0), (0,0.25], (0.25,05], (0.5075] and (0.75,1.0] was 75.6, 40.3, 24.1, 18.8 and 16.4 months, respectively. A multi-variant analysis demonstrated that each LODDS category is an independent prognostic factor: (-4,-3] (HR = 0.982; 95% CI 0.867-1.112; P = 0.775), (-3,-2] (HR = 1.114; 95% CI 0.984-1.262; P = 0.089), (-2,-1] (HR = 1.241; 95% CI 1.080-1.425; P = 0.002), (-1,0] (HR = 1.617; 95% CI 1.385-1.887; P < 0.0001), (0,1] (HR = 1.918; 95% CI 1.579-2.329; P < 0.0001) and (1,2] (HR = 2.016; 95% CI 1.579-2.573; P < 0.0001).


CONCLUSIONS
Based on LODDS it is possible to discriminate patients with regard to lung cancer stage more effectively compared to pN and LNR classification, and it is also a better classification system.
Department of Thoracic Surgery, National Research Institute of Chest Diseases, Plocka 26, 01-138, Warsaw, Poland. Electronic address: drdariuszdziedzic@gmail.com.
Dariusz
D
Dziedzic
Department of Thoracic Surgery, National Research Institute of Chest Diseases, Plocka 26, 01-138, Warsaw, Poland.
Rudzinski
R
Piotr
Department of Patomorphology, National Research Institute of Chest Diseases, Warsaw, Poland.
Renata
R
Langfort
Department of Thoracic Surgery, National Research Institute of Chest Diseases, Plocka 26, 01-138, Warsaw, Poland.
Tadeusz
T
Orlowski
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
Log odds; Lung cancer; Lymph node ratio