ArticleAnnals of surgical oncology2026
N-LODDS: A Novel Integrated Lymph Node Staging System Enhancing Prognostic Accuracy in Non-Small-Cell Lung Cancer.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to develop and validate a novel lymph node staging system integrating anatomical location and quantitative characteristics, evaluate its prognostic prediction efficacy in non-small-cell lung cancer (NSCLC), and establish a multivariate prognostic model.
methodsA total of 23,676 patients with NSCLC from the SEER database (2010-2015) were enrolled. Optimal cutoffs for lymph node parameters (NPLN, LNR, LODDS) were determined using X-tile software. Composite variables (N-NPLN, N-LNR, N-LODDS) were constructed by integrating N staging. Independent prognostic factors were screened via Cox regression, and a nomogram was developed. Performance was assessed using the receiver operating characteristic curves, calibration curves, and decision curve analysis.
resultsN-LODDS staging demonstrated optimal prognostic prediction, significantly outperforming N-LNR and N-NPLN. The nomogram incorporating N-LODDS, tumor size, and nine independent prognostic factors showed superior discrimination and calibration (5 year area under the curve 0.740; 95% confidence interval 0.731-0.749) in both training and validation cohorts, with significant advantages over the TNM staging system (all P<0.001).
conclusionThe N-LODDS staging system significantly improves prognostic accuracy by integrating anatomical and quantitative lymph node features, providing a novel tool for personalized NSCLC management. Future multicenter prospective studies are needed to validate its clinical utility.
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