ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2020
Beyond Margin Status: Population-Based Validation of the Proposed International Association for the Study of Lung Cancer Residual Tumor Classification Recategorization.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 63 citations in OpenAlex.
- ASO Editorial: Beyond Negative Margins-What Does Uncertain Resection Really Mean?Annals of surgical oncology · 2026Article
- Highest mediastinal lymph node metastasis was not an independent prognostic factor in pathological stage N2 non-small cell lung cancer.Translational lung cancer research · 2026Article
- Inconsistent definitions of radical resection in perioperative trials of non-small cell lung cancer: a scoping review.Translational lung cancer research · 2026Review
- Tumor stage, squamous histology and male sex predict positive resection margins in non-small cell lung cancer patients undergoing anatomical resection-a retrospective study from a high-volume thoracic surgery unit.Journal of thoracic disease · 2026Article
- Prognostic Significance of the Uncertain Resection Based on the Extent of Nodal Dissection in Non-small-Cell Lung Cancer.Annals of surgical oncology · 2026Article
- ASO Author Reflections: Suboptimal Nodal Dissection Could Undermine Long-Term Survival in Patients with Non-Small-Cell Lung Cancer.Annals of surgical oncology · 2026Article
- Surgical nodal sampling established by Commission on Cancer Standard 5.8 is essential for accurate lung cancer staging.JTCVS open · 2026Article
- Hilar Lymphadenectomy Is Associated With Improved Disease-Free Survival in Pathologically N0 Non-Small Cell Lung Cancer.World journal of surgery · 2026Article
- [Clinical Significance of Extranodal Extension in Non-small Cell Lung Cancer: Current Status and Future Prospects].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Review
- Mediastinal staging of nonsmall cell lung cancer: what's new?Breathe (Sheffield, England) · 2025Review
- Article
- Review
- Recurrence Dynamics of Pathological N2 Non-Small Cell Lung Cancer Based on IASLC Residual Tumor Descriptor.Cancer research and treatment · 2025Article
- The IASLC uncertain resection, general overview, current evidence, and future prospects: a systematic review and meta-analysis.Therapeutic advances in medical oncology · 2025Review
- Lymphatic vascular invasion: Diagnostic variability and overall survival impact on patients undergoing surgical resection.JTCVS open · 2024Article
- ASO Author Reflections: The Prognostic Significance of the Highest Mediastinal Lymph Node Involvement in Non-small Cell Lung Cancer Patients.Annals of surgical oncology · 2024Article
- Prognostic Significance of the Highest Mediastinal Lymph Node Involvement in Patients with Stage III-N2 Non-small Cell Lung Cancer.Annals of surgical oncology · 2024Article
- Program-Based Lung Cancer Care: A Prospective Observational Tumor Registry Linkage Study.JTO clinical and research reports · 2024Article
- Residual tumor descriptors proposed by the International Association for the Study of Lung Cancer may not be applicable to stage I and ground-glass opacity-featured non-small cell lung cancer.Translational lung cancer research · 2023Article
- Meta-Analysis of Rates and Risk Factors for Local Recurrence in Surgically Resected Patients With NSCLC and Differences Between Asian and Non-Asian Populations.JTO clinical and research reports · 2023Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
introductionThe International Association for the Study of Lung Cancer's (IASLC's) proposal to recategorize the residual tumor (R) classification for resected NSCLC needs validation.
methodsUsing a 2009 to 2019 population-based multi-institutional NSCLC resection cohort from the United States, we classified resections by Union for International Cancer Control (UICC) and IASLC R criteria and compared the distribution of R classification variables and their survival associations.
resultsOf 3361 resections, 95.3% were R0, 4.3% were R1, and 0.4% were R2 by UICC criteria; 33.3% were R0, 60.8% were R-uncertain, and 5.8% were R1/2 by IASLC criteria; 2044 patients (63.8%) migrated from UICC R0 to IASLC R-uncertain. Median survival was not reached, 69 (95% confidence interval [CI]: 64-77), and 25 (95% CI: 18-36) months, respectively, for patients with IASLC R0, R-uncertain, and R1 or R2 resections. Failure to achieve nodal dissection criteria caused 98% of migration to R-uncertainty, metastasis to the highest mediastinal node station, 5.8%. Compared with R0, R-uncertain resections with mediastinal nodes, no mediastinal nodes, and no nodes had adjusted hazard ratios of 1.28 (95% CI: 1.10-1.48), 1.47 (95% CI: 1.24-1.74), and 1.74 (95% CI: 1.37-2.21), respectively, suggesting a dose-response relationship between nodal R-uncertainty and survival. Accounting for mediastinal nodal involvement, the highest mediastinal station involvement was not independently prognostic. The incomplete resection variables were uniformly prognostic.
conclusionsThe proposed R classification recategorization variables were mostly prognostic, except the highest mediastinal nodal station involvement. Further categorization of R-uncertainty by severity of nodal quality deficit should be considered.
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