国际肺癌研究协会新提出的第9版TNM分期N分期的验证研究

The aim of this study was to validate the discriminatory ability and clinical utility of the N descriptor of the newly proposed 9th edition of the TNM staging system for lung cancer in a large independent cohort.

We retrospectively analyzed patients who underwent curative surgery for non-small cell lung cancer (NSCLC) between January 2004 and December 2019. The N descriptor of patients included in this study was retrospectively reclassified based on the 9th edition of the TNM classification. Survival analysis was performed using the log-rank test and Cox proportional hazard model to compare adjacent N categories.

A total of 6649 patients were included in this study. The median follow-up period was 54 months. According to the newly proposed 9th edition N classification, 5573 (83.8%), 639 (9.6%), 268 (4.0%), and 169 (2.5%) patients were classified into the clinical N0, N1, N2a, and N2b categories and 4957 (74.6%), 744 (11.2%), 567 (8.5%), and 381 (5.7%) were classified into the pathologic N0, N1, N2a, and N2b categories, respectively. The prognostic differences between all adjacent clinical and pathologic N categories were highly significant in terms of both overall survival (OS) and recurrence free survival (RFS).

We validated the clinical utility of the newly proposed 9th edition N classification for both clinical and pathologic stages in NSCLC. The new N classification showed clear prognostic separation between all categories (N0, N1, N2a, and N2b) in terms of both OS and RFS.