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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2022

18-08-2022 | Lung Cancer | Thoracic Oncology

A Comprehensive Comparison of Different Nodal Subclassification Methods in Surgically Resected Non-Small-Cell Lung Cancer Patients

Authors: Zihuai Wang, MD, Zhenyu Yang, MD, Sijia Li, MD, Junqi Zhang, MD, Liang Xia, MD, Jian Zhou, MD, Nan Chen, MD, Chenglin Guo, MD, Lunxu Liu, MD, PhD, FRCS

Published in: Annals of Surgical Oncology | Issue 13/2022

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Abstract

Introduction

The revision of the N descriptor in non-small-cell lung cancer has been widely discussed in the past few years. Many different subclassification methods based on number or location of lymph nodes have been proposed for better distinguishing different N patients. This study aimed to systematically collect them and provide a comprehensive comparison among different subclassification methods in a large cohort.

Method

Pathological N1 or N2 non-small-cell lung cancer patients undergoing surgical resection between 2005 and 2016 in the Western China Lung Cancer Database were retrospectively reviewed. A literature review was conducted to collect previous subclassification methods. Kaplan-Meier and multivariable Cox analyses were used to examine the prognostic performance of subclassification methods. Decision curve analysis, Akaike’s information criterion, and area under the receiver operating curve concordance were also performed to evaluate the standardized net benefit of the subclassification methods.

Results

A total of 1625 patients were identified in our cohort. Eight subclassification methods were collected from previous articles and further grouped into subclassification based on number categories (node number or station number), location categories (lymph node zone or chain) or combination of number and location categories. Subclassification based on combination of lymph node location and number tended to have better discrimination ability in multivariable Cox analysis. No significant superiority among the different subclassification methods was observed in the three statistical models.

Conclusion

Subclassification based on the combination of location and number could be used to provide a more accurate prognostic stratification in surgically resected NSCLC and is worth further validation.
Appendix
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Metadata
Title
A Comprehensive Comparison of Different Nodal Subclassification Methods in Surgically Resected Non-Small-Cell Lung Cancer Patients
Authors
Zihuai Wang, MD
Zhenyu Yang, MD
Sijia Li, MD
Junqi Zhang, MD
Liang Xia, MD
Jian Zhou, MD
Nan Chen, MD
Chenglin Guo, MD
Lunxu Liu, MD, PhD, FRCS
Publication date
18-08-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12363-w

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