ArticleCancer research and treatment2025
Differences in the Prognostic Impact between Single-Zone and Multi-Zone N2 Node Metastasis in Patients with Station-Based Multiple N2 Non-Small Cell Lung Cancer.
Article in Cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- 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
- Comparison Between Lymph Node Station- and Zone-Based Classification: An Extended Analysis With the Ninth Edition TNM Lymph Node Descriptors in Surgically Resected NSCLC.JTO clinical and research reports · 2026Article
- Prognostic impacts of skip metastasis in N2a and N2b subgroups of non-small cell lung cancer: insights from a large cohort.Translational lung cancer research · 2025Article
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8 authors.
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Abstract
purposeThe International Association for the Study of Lung Cancer suggests further subdivision of pathologic N (pN) category in non-small-cell lung cancer (NSCLC) by incorporating the location and number of involved lymph node (LN) stations. We reclassified patients with the station-based N2b disease into single-zone and multi-zone N2b groups and compared survival outcomes between the groups. MATERIALS AND
methodsThis retrospective study included patients with pN2 NSCLC who underwent lobectomy from 2006 to 2019. The N2 disease was subdivided into four categories: single-station N2 without N1 (N2a1), single-station N2 with N1 (N2a2), multiple-station N2 with single zone involvement (single-zone N2b), and multiple-station N2 with multiple zone involvement (multi-zone N2b). LN zones included in the subdivision of N2 disease were upper mediastinal, lower mediastinal, aortopulmonary, and subcarinal.
resultsAmong 996 eligible patients, 211 (21.2%), 394 (39.6%), and 391 (39.3%) were confirmed to have pN2a1, pN2a2, and pN2b disease, respectively. In multivariable analysis after adjustment for sex, age, pT category, and adjuvant chemotherapy, overall survival was significantly better with single-zone N2b disease (n=125, 12.6%) than with multi-zone N2b disease (n=266, 26.7%) (hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.49 to 0.90; p=0.009) and was comparable to that of N2a2 disease (HR, 1.12; 95% CI, 0.83 to 1.49; p=0.46).
conclusionPrognosis of single-zone LN metastasis was better than that of multiple-zone LN metastasis in patients with N2b NSCLC. Along with the station-based N descriptors, zone-based descriptors might ensure optimal staging, enabling the most appropriate decision-making on adjuvant therapy for patients with pN2 NSCLC.
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