ArticleBMC cancer2025
Validation for revision of the stage IIIA(T1N2) in the forthcoming ninth edition of the TNM classification for lung cancer.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Survival impact of pN2a and pN2b nodal status in stage IIB-IIIB non-small cell lung cancer under the 9Turk gogus kalp damar cerrahisi dergisi · 2026Article
- Redefining the Diagnostic and Therapeutic Landscape of Non-Small Cell Lung Cancer in the Era of Precision Medicine.Journal of clinical medicine · 2025Review
- Differences Between the 8th and 9th Editions of the TNM Staging System in Predicting Mortality in Non-Small Cell Lung Cancer Patients Staged with EBUS.Diagnostics (Basel, Switzerland) · 2025Article
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5 authors.
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Abstract
objectivesThe 9th edition of the lung cancer tumor-node-metastasis (TNM) staging system downgrades certain non-small cell lung cancer (NSCLC) patients from stage IIIA (T1N2) to IIB(T1N2a). This study aimed to externally validate this stage adjustment.
methodsConsecutive resected stage IIB and IIIA (the 9th edition of lung cancer TNM staging manual) NSCLC patients were included. Stage IIB was divided into groups A, B, and C according to lymph node involvement. Group A, patients who having single-station N2 without N1 involvement; Group B, patients who having single-station N2 with N1 involvements; Group C, patients who having station N1 involvement or N0. The stage IIIA patients divided into Group D. Overall survival (OS) and disease-free survival (DFS) were compared using the Kaplan-Meier method, with propensity score matching (PSM) employed to mitigate potential biases. COX regression models were utilized to assess prognostic differences.
results224 stage IIB and 227 stage IIIA cases was included. There were 38, 66 and 120 patients in the Group A, B and C, respectively. Univariate COX analysis indicated comparable prognoses between the Group A and Group C patients, whereas Group B patients exhibited poorer outcomes. Upon combining the Group A and Group C patients, multivariate COX analysis demonstrated a significantly worse prognosis for Group B patients compared to those with Group A + C patients (OS, P = 0.035; DFS, P = 0.021). Further comparisons between Group B and Group D patients, following PSM analysis, indicated similar survivals (OS: P = 0.390; DFS: P = 0.210).
conclusionIn the 9th edition of the lung cancer TNM staging system, the prognosis of stage IIB N2a2 patients was worse than that of remaining stage IIB patients but comparable to that of stage IIIA patients. We proposed that stage IIB N2a2 patients should be maintained as stage IIIA.
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