Counting cancerous lymph nodes is best predictor of mortality across most cancers

Patients newly diagnosed with cancer typically focus on one question, eclipsing all others: “What is my prognosis?”

Determining a cancer patient’s prognosis — the likely course and outcome of their disease — typically involves staging the lymph nodes, a process that examines factors such as the lymph node’s size, location and how far the cancer has extended beyond the node. Lymph node staging, however, currently is highly variable, depending on the cancer site, said Zachary S. Zumsteg, MD, assistant professor of Radiation Oncology at Cedars-Sinai Cancer. Because staging helps determine which treatments patients receive, getting it right should be consistent, accurate and universal, which is not always the case, he added.

A study co-led by Zumsteg, recently published in the Journal of the National Cancer Institute,has confirmed the effectiveness of a universal lymph node staging process that potentially may do just that.

“Count the number of metastatic lymph nodes,” Zumsteg said. “We found that this simple process is much better for determining prognoses for solid tumors than all the other factors used today. It should be the backbone of nodal staging because it is the best predictor of mortality, irrespective of the disease site.”

To test their hypothesis that metastatic nodal counting could be used to generate objective and reproducible nodal classification systems for all solid tumors, the researchers performed a retrospective analysis of nearly 1.3 million patients from the National Cancer Database who were diagnosed between 2004 and 2015. The researchers also used data from an additional 2 million patients from the Surveillance, Epidemiology, and End Results registry.

Their findings, validated across 16 of the most common solid cancers in the United States, confirmed that the number of cancerous lymph nodes is a dominant predictor of cancer death. Investigators also found that consistently, across disease sites, patient mortality risk increased continuously with the increasing number of metastatic lymph nodes.

Source: Read Full Article