ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2024
The International Association for the Study of Lung Cancer Staging Project for Lung Cancer: Proposals for the Revision of the N Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 69 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
69 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rates of Nodal Upstaging following Systematic Endobronchial Ultrasound Lymph Node Staging in Non-Metastatic Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.Respiration; international review of thoracic diseases · 2026Pooled it
- Conversion Surgery After Induction Therapy for Initially Unresectable Stage III Non-small Cell Lung Cancer: A Proof-of-Concept Trial.Annals of surgical oncology · 2026Trial
- Observational
- The 9th Edition of the UICC TNM Classification of Malignant Tumours: Updates and Rationale for Change.International journal of cancer · 2026Review
- Long-term Outcomes of Surgery for Clinical T4 Non-Small Cell Lung Cancer: Implications for Surgical Decision Making in the TNM 9th Edition Era.Annals of surgical oncology · 2026Observational
- Distinct recurrence patterns related to preoperative treatment decisions for patients with locally advanced non-small cell lung cancer.Surgery today · 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
- Prognostic impact of stage reclassification and N2 subclassification in the ninth edition of TNM classification for non-metastatic lung cancer.Annals of nuclear medicine · 2026Article
- Should we optimise or revise the management of initially unresectable stage III non-small cell lung cancer: rethinking consolidation therapy.Journal of the National Cancer Center · 2026Article
- Review
- Article
- Prognostic significance of nodal subclassification and adjuvant therapy in surgically treated T1-4N1-2M0 non-small cell lung cancer: a single-center retrospective study.BMC pulmonary medicine · 2026Article
- Current advances in extended resections for non-small cell lung cancer-a narrative review.Translational lung cancer research · 2026Review
- Contemporary Lung Cancer Nodal Staging and Therapeutic Decision-Making in the 9th TNM Era.Cancers · 2026Review
- Upfront surgery for clinical single-station N2 non-small cell lung cancer: real-world outcomes and implications for perioperative strategy.General thoracic and cardiovascular surgery · 2026Article
- A Pilot Study on Quantitative Accuracy and Radiomic Feature Stability of Deep Progressive Learning Reconstruction in NSCLC PET.Journal of imaging informatics in medicine · 2026Article
- N1 Staging in Non-Small Cell Lung Cancer: Current Situation, Limitations, and the Importance of Peripheral Nodal Assessment.Cancers · 2026Review
- Rethinking pN1 Disease in Non-Small Cell Lung Cancer: Anatomical Subclassification, Surgical Extent, and Survival Outcomes.Journal of clinical medicine · 2026Article
- Segmentectomy achieves comparable survival outcomes compared to lobectomy in peripheral ≤3 cm non-small cell lung cancer with occult lymph node metastases.Journal of thoracic disease · 2026Article
- Comparison of Mediastinal Metastases of Primary Lung Cancer Versus Extrathoracic Malignancies in Patients Obtained with Endobronchial Ultrasonography-Guided Transbronchial Needle Aspiration Biopsy: A Single-Center Retrospective Study.Medicina (Kaunas, Lithuania) · 2026Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
24 authors.
Funding
Abstract
introductionThe accurate assessment of nodal (N) status is crucial to the management and prognostication of nonmetastatic NSCLC. We sought to determine whether the current N descriptors should be maintained or revised for the upcoming ninth edition of the international TNM lung cancer staging system.
methodsData were assembled by the International Association for the Study of Lung Cancer on patients with NSCLC, detailing both clinical and pathologic N status, with information about anatomical location and individual station-level identification. Survival was calculated by the Kaplan-Meier method and prognostic groups were assessed by a Cox regression analysis.
resultsData for clinical N and pathologic N status were available in 45,032 and 35,009 patients, respectively. The current N0 to N3 descriptors for both clinical N and pathologic N categories reflect prognostically distinct groups. Furthermore, single-station N2 involvement (N2a) exhibited a better prognosis than multistation N2 involvement (N2b) in both clinical and pathologic classifications, and the differences between all neighboring nodal subcategories were highly significant. The prognostic differences between N2a and N2b were robust and consistent across resection status, histologic type, T category, and geographic region.
conclusionsThe current N descriptors should be maintained, with the addition of new subdescriptors to N2 for single-station involvement (N2a) and multiple-station involvement (N2b).
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