ArticleThe clinical respiratory journal2023
Comparative analysis of methodologies for predicting overall survival in patients with non-small cell lung cancer based on the number and rate of resected positive lymph nodes: A study based on the SEER database for 2010 through 2019.
Article in The clinical respiratory journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic value of lymph node ratio in patients with non-small cell lung cancer: a systematic review and meta-analysis.Frontiers in oncology · 2025Pooled it
- Lymph nodes metastatic burden as a prognosticator for advanced non-small cell lung cancer: a real-world study.Journal of thoracic disease · 2025Article
- Recommended optimal range for the count of examined lymph nodes and lymph node ratio for postoperative adjuvant radiotherapy in patients with pN2 non-small cell lung cancer: a multicenter retrospective cohort investigation.Journal of thoracic disease · 2025Article
- Is It Time to (Re)define the N-Category for Metastatic Lymph Nodes in Non-Small Cell Lung Cancer?The clinical respiratory journal · 2024Article
- Comparative analysis of methodologies for predicting overall survival in patients with non-small cell lung cancer based on the number and rate of resected positive lymph nodes: A study based on the SEER database for 2010 through 2019.The clinical respiratory journal · 2023Article
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7 authors.
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Abstract
backgroundLymph node (LN) metastasis is crucial in non-small cell lung cancer (NSCLC) prognosis and treatment, but the TNM system lacks LN quantity consideration. Our goal is to investigate the role of positive LNs (nPLN) and positive LN rate (LNR) in overall survival (OS) and assess whether they offer higher value in prognostic assessment of NSCLC than N-stage.
methodsPatients were stratified into four subgroups using X-Tile software. Statistical analysis was conducted using the Kaplan-Meier method, univariate analysis, and multivariate Cox regression analysis. Model performance was evaluated using the Harrell consistency index (C-index), Akaike information criterion (AIC), and Bayesian information criterion (BIC). The prognostic performance of the nodal classification was validated using overall survival as the endpoint.
resultsThe survival curves demonstrate distinct disparities between each nPLN and LNR category. A pronounced trend toward deteriorating overall survival from N-PLN 1 to N-PLN 2+ was observed across all tumor size categories. However, the differences between each LNR category were only significant for tumors ≤3 cm and 5-7 cm. Notably, both nPLN and LNR classifications displayed a higher C-index, lower AIC, and lower BIC compared with the N staging. Furthermore, the LNR classification provided superior prognostic stratification when compared with the nPLN classification.
conclusionsOur results demonstrate that nPLN and LNR classifications may offer improved prognostic performance compared with the current N classification for LN-positive NSCLC patients. Nonetheless, more studies are needed to assess the feasibility of incorporating these classifications into the next TNM staging system.
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