ArticleQuantitative imaging in medicine and surgery2026
Prognostic value of pretherapy CT-based Node-RADS for overall survival in extensive-stage small cell lung cancer treated with chemoimmunotherapy: a comparison with clinical N staging.
Article in Quantitative imaging in medicine and surgery, 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
Background: The Node Reporting and Data System (Node-RADS) provides a standardized and effective assessment of lymph nodes, but its relationship with the prognosis of small cell lung cancer (SCLC) remains unknown. This study aimed to assess the value of Node-RADS for predicting overall survival (OS) in extensive-stage SCLC patients treated with chemoimmunotherapy. Methods: The clinical data including OS of 297 patients with extensive-stage SCLC who underwent chemoimmunotherapy were collected retrospectively. On the pretherapeutic chest computed tomography (CT) scans, we evaluated the maximum Node-RADS score per patient and the number of positive nodal stations, defined using two thresholds: LNM-Station3 (score ≥3) and LNM-Station4 (score ≥4). The Clinical-NR3 model, incorporating pretreatment clinical variables, the maximum Node-RADS score, and LNM-Station3, was developed using Cox regression analyses to predict OS. Similarly, the Clinical-NR4 model was constructed using clinical variables, the Maximum Node-RADS score, and LNM-Station4, whereas the Clinical-cN model was created as a control based on the clinical variables and cN stage. Results: LNM-Station3 and LNM-Station4 acted as independent predictors for OS in the Clinical-NR3 and Clinical-NR4 models, respectively. The cN stage was not significantly associated with OS in the Clinical-cN model (P>0.05). The Clinical-NR4 model demonstrated a higher concordance index (C-index) than the Clinical-cN model (0.759 Conclusions: The baseline LNM-Station based on Node-RADS is an effective prognostic indicator for extensive-stage SCLC. The pretherapeutic CT-based Node-RADS models provide incremental prognostic value beyond conventional clinical N (cN) staging in patients with SCLC.
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