ArticleJournal of thoracic disease2026
Patterns and risk factors of lymph node metastasis in non-small cell lung cancer 2 cm or less.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Lobe-Specific Versus Systematic Lymph Node Dissection in Clinical Stage I Non-Small Cell Lung Cancer: A Propensity Score-Matched Analysis Based on the 8th Edition of the TNM Stage Classification.Thoracic cancer · 2026Article
- Mediastinal lymph node metastasis pattern of subsolid non-small cell lung cancer.Journal of thoracic disease · 2026Article
- Station 7 metastasis in upper lobe non-small cell lung cancer ≤2 cm: anatomical anomaly or marker of tumor aggressiveness?Journal of thoracic disease · 2026Article
- The diagnostic efficacy of venous-phase spectral CT combined with Node-RADS for differentiating enlarged lymph nodes in common solid tumors: a preliminary exploratory study.Frontiers in oncology · 2026Article
- Methylation of DPP9 regulates immune surveillance in non-small cell lung cancer by promoting macrophage ferroptosis via WWP2 ubiquitination.American journal of cancer research · 2026Article
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Abstract
Background: With the widespread use of computerized tomography (CT) screening, early-stage small-sized (≤2 cm) non-small cell lung cancer (NSCLC) is increasingly detected. However, the optimal extent of lymph node (LN) dissection for these patients remains controversial. This study aimed to comprehensively investigate the patterns and risk factors of LN metastasis in NSCLC ≤2 cm to guide more precise and individualized surgical management. Methods: We conducted a retrospective analysis of 1,878 patients with clinical N0 NSCLC ≤2 cm who underwent surgical resection with adequate LN dissection at our institution between December 2009 and November 2019. Univariate and multivariate logistic regression were used to identify risk factors for LN metastasis. Results: The overall LN metastasis rate was 5.6% (106/1,878). Metastasis rates by lobe were: right upper lobe 4.8% (34/712), right middle lobe 5.3% (10/187), right lower lobe 5.6% (17/305), left upper lobe 6.8% (26/384), and left lower lobe 6.6% (19/290). Upper lobe tumors primarily involved upper mediastinal nodes, while lower lobe tumors mainly metastasized to lower mediastinal nodes. Station 7 metastasis occurred in five upper lobe tumors, all measuring ≥1 cm with pure solid appearance. Multivariate analysis identified tumor size ≥1 cm [odds ratio (OR) =64.41, 95% confidence interval (CI): 9.95-877.52], pure solid radiological appearance (OR =7.88, 95% CI: 4.63-14.37), ≥10 LNs removed (OR =1.64, 95% CI: 1.01-2.76), adenosquamous carcinoma (OR =6.02, 95% CI: 2.27-15.76), and pleural invasion (OR =3.66, 95% CI: 2.17-6.11) as independent risk factors. No LN metastasis occurred in tumors <1 cm or pure ground-glass opacity (GGO) nodules. Conclusions: Lobe-specific LN dissection is recommended for NSCLC ≤2 cm. For upper lobe tumors ≥1 cm with pure solid appearance, station 7 dissection should be considered. LN dissection may be omitted for pure GGO nodules or tumors ≤1 cm.
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