Evidence map›Paper›PMID 42723359›Full record

ArticleThoracic cancer2026

Extent of Endobronchial Ultrasound Nodal Sampling and Risk of Pathologic N2 Upstaging in Clinical N0-N1 Non-Small Cell Lung Cancer.

Min Jee Kim, Jae Cheol Lee, Chang-Min Choi, Sei Won Lee, Jae Seung Lee, Kyung-Wook Jo, Ho Cheol Kim, Jee Hwan Ahn, Jang Ho Lee, Dong-Gon Hyun and 1 more

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Article in Thoracic cancer, 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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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Min Jee KimDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0003-0073-2079
Jae Cheol LeeDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0001-5963-0259
Chang-Min ChoiDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0002-2881-4669
Sei Won LeeDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0003-4814-6730
Jae Seung LeeDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kyung-Wook JoDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0002-5949-248X
Ho Cheol KimDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0002-3154-4858
Jee Hwan AhnDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0001-6653-998X
Jang Ho LeeDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0002-8226-9585
Dong-Gon HyunDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0001-5434-2223
Wonjun JiDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0001-7164-2770

Funding

Asan Institute for Life Sciences, Asan Medical Center 2024IL0014
6 · The paper itself

Abstract

backgroundEndobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is strongly recommended for mediastinal staging in resectable non-small cell lung cancer (NSCLC). However, the optimal sampling extent remains uncertain. This study aimed to evaluate whether the extent of nodal sampling during staging EBUS is associated with pathologic N2 upstaging in clinical N0-N1 NSCLC.

methodsThis retrospective cohort included patients with cN0-N1 NSCLC who underwent preoperative EBUS-TBNA between January 2022 and December 2023. Patients were stratified into three groups according to the number of sampled lymph node stations at the N2/N3 levels: Group 1, ≤ 1 mediastinal station at N2 or N3; Group 2, one N2 and one N3 station; Group 3, ≥ 3 stations, including at least one N2 and one N3. The primary outcome was pathologic N2 upstaging, defined as N2 disease confirmed on surgical pathology despite preoperative stage N0-N1.

resultsA total of 418 patients were included (mean age, 68.6 years; 64.1% male). Most had adenocarcinoma (75.4%) and cN0 disease (94.7%). Group distribution was 140 (33.5%) in Group 1, 92 (22.0%) in Group 2, and 186 (44.5%) in Group 3. Pathologic N2 upstaging occurred in 21/140 (15.0%) in Group 1, 8/92 (8.7%) in Group 2, and 8/186 (4.3%) in Group 3. The rate decreased with increasing sampling, with Group 3 showing a lower rate than Group 1 (p = 0.005).

conclusionsComprehensive staging EBUS-TBNA with ≥ 3 N2/N3 stations was associated with a lower rate of occult N2 upstaging in clinical N0-N1 NSCLC, underscoring the importance of comprehensive nodal evaluation for accurate staging.

Indexed as

Carcinoma, Non-Small-Cell LungEndoscopic Ultrasound-Guided Fine Needle AspirationEndosonographyLung NeoplasmsLymph NodesAgedFemaleHumansMaleMiddle AgedNeoplasm StagingRetrospective Studiessampling extentstaging endobronchial ultrasoundupstaging N2

Identifiers

PMID42723359
PMCPMC13562910

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.