Objectives

We aimed to clarify the incidence of lymph node (LN) metastasis and its predictive factors in clinical stage IA squamous cell carcinoma (SqCC) based on radiological classification to provide surgical indications for segmentectomy.

Methods

We retrospectively reviewed 192 patients with clinical stage IA SqCC who underwent complete resection with lobectomy and LN dissection at our institution between 2003 and 2019. To evaluate the incidence of LN metastasis from the perspective of indications for segmentectomy, we classified them into outer and inner groups based on the location of the tumor in the radiological findings.

Results

Regarding tumor location, 123 patients had tumors in the outer location and 69 patients had tumors in the inner location. The incidence of LN metastasis was 6% in clinical stage IA SqCC, which included 6% in the outer location and 7% in the inner location (p = 0.669). In the outer location, all LN metastases were in N1 (6%); whereas in the inner location, the incidence of N1 and N2 metastasis were 6% and 1%, respectively. Only tumors sized > 2.0 cm were found to be significantly associated with LN metastasis in clinical stage IA SqCC.

Conclusions

We demonstrated that the incidence of LN metastasis in clinical stage IA SqCC was comparable to that of the previously reported clinical stage IA NSCLC. The incidence of LN metastasis in the outer location was similar to that in the inner location. Tumor size was only a significant factor affecting LN metastasis in clinical stage IA SqCC.

中文翻译：

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基于放射学检查的临床IA期肺鳞状细胞癌的淋巴结转移和预测因素

目标

我们旨在根据放射学分类阐明临床 IA 期鳞状细胞癌 (SqCC) 中淋巴结 (LN) 转移的发生率及其预测因素，为肺段切除术提供手术指征。

方法

我们回顾性分析了 2003 年至 2019 年间在我院接受肺叶切除和 LN 清扫的 192 例临床 IA 期 SqCC 患者。为了从肺段切除适应症的角度评估 LN 转移的发生率，我们将他们分为外组和内组根据放射学发现的肿瘤位置。

结果

关于肿瘤位置，123 名患者的肿瘤位于外部，69 名患者的肿瘤位于内部。临床分期 IA SqCC LN 转移的发生率为 6%，其中外侧部位为 6%，内侧部位为 7%（p  = 0.669）。在外部位置，所有 LN 转移都在 N1（6%）；而在内部位置，N1 和 N2 转移的发生率分别为 6% 和 1%。在临床 IA 期 SqCC 中，仅发现大小 > 2.0 cm 的肿瘤与 LN 转移显着相关。

结论

我们证明了临床 IA 期 SqCC 中 LN 转移的发生率与先前报道的临床 IA 期 NSCLC 的发生率相当。外部位置的LN转移发生率与内部位置相似。肿瘤大小仅是影响临床 IA 期 SqCC 中 LN 转移的重要因素。