Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Copyright © 2025 by the Korean Cancer Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ethical Statement
The need for informed consent from patients was waived by institutional review board from Asan Medical Center (approval no. 2022-1322, approval date : September 22, 2022).
Author Contributions
Conceived and designed the analysis: Kim S, Lee GD, Choi S, Kim HR, Kim YH, Kim DK, Park SI, Yun JK.
Collected the data: Kim S.
Contributed data or analysis tools: Kim S, Lee GD, Choi S, Kim HR, Kim YH, Kim DK, Park SI, Yun JK.
Performed the analysis: Kim S.
Wrote the paper: Kim S, Yun JK.
Supervision: Yun JK.
Conflict of Interest
Conflict of interest relevant to this article was not reported.
N2 | Description |
---|---|
N2a1 | Single-station N2 without N1 involvement |
N2a2 | Single-station N2 with N1 involvement |
Single-zone N2b | Multi-station and single-zone N2 involvement |
Multi-zone N2b | Multi-station and multi-zone N2 involvement |
Characteristic | Value |
---|---|
Age (yr) | 62 (55-69) |
Sex | |
Male | 607 (60.9) |
Female | 389 (39.1) |
Histologic structure | |
ADC | 747 (75.0) |
SqCC | 219 (22.0) |
Other | 30 (3.0) |
Operative method | |
Lobectomy | 888 (89.2) |
Bilobectomy | 65 (6.5) |
Pneumonectomy | 43 (4.3) |
Comorbidities per patient | |
0 | 337 (33.8) |
1 | 336 (33.7) |
2 | 213 (21.4) |
Over 3 | 110 (11.0) |
Tumor size (mm) | 35 (25-45) |
Tumor location | |
Right upper | 276 (27.7) |
Right middle | 70 (7.0) |
Right lower | 243 (24.4) |
Left upper | 238 (23.9) |
Left lower | 164 (16.5) |
8th pathologic tumor factor | |
pT1 | 247 (24.8) |
pT2 | 496 (49.8) |
pT3 | 171 (17.2) |
pT4 | 82 (8.2) |
8th pathologic node factor | |
pN2a1 | 211 (21.2) |
pN2a2 | 394 (39.6) |
pN2b | 391 (39.3) |
Single-zone pN2b | 125 (12.6) |
Multi-zone pN2b | 266 (26.7) |
8th pathologic stage | |
IIIA | 743 (74.6) |
IIIB | 253 (25.4) |
Adjuvant therapy | |
Yes | 854 (85.7) |
No | 142 (14.3) |
CCRTx | 284 (28.5) |
CTx | 444 (44.6) |
RTx | 352 (35.3) |
Time variable | |
Early (surgery from 2006 to 2012) | 414 (41.6) |
Late (surgery from 2012 to 2019) | 582 (58.4) |
Total number of dissected LN (n) | 28 (21-36) |
Multi-zone N2b (n=266) | Single-zone N2b (n=125) | p-value | |
---|---|---|---|
Sex | |||
Male | 143 (53.8) | 75 (60.0) | 0.294 |
Female | 123 (46.2) | 50 (40.0) | |
Age (yr) | 60.5 (54-68) | 62 (56-69) | 0.643 |
Histologic diagnosis | |||
Adenocarcinoma | 224 (84.2) | 106 (84.8) | 0.999 |
Squamous cell carcinoma | 33 (12.4) | 14 (11.2) | 0.861 |
Other | 9 (3.4) | 5 (4.0) | 0.989 |
8th pathologic tumor factor | |||
pT1 | 60 (22.6) | 35 (28.0) | 0.406 |
pT2 | 127 (47.7) | 62 (49.6) | |
pT3 | 56 (21.1) | 21 (16.8) | |
pT4 | 23 (8.6) | 7 (5.6) | |
8th clinical tumor factor | |||
cT1 | 82 (30.8) | 46 (36.8) | 0.361 |
cT2 | 121 (45.5) | 62 (49.6) | |
cT3 | 45 (16.9) | 11 (8.8) | |
cT4 | 18 (6.8) | 6 (4.8) | |
8th clinical node factor | |||
cN0 | 106 (39.8) | 53 (42.4) | 0.252 |
cN1 | 48 (18.0) | 14 (11.2) | |
cN2 | 110 (41.4) | 58 (46.4) | |
cN3 | 2 (0.8) | 0 | |
Comorbidities per patient | 1 (0-2) | 1 (0-2) | 0.176 |
Adjuvant therapy | |||
CTx | 91 (34.2) | 49 (39.2) | 0.397 |
RTx | 111 (41.7) | 49 (39.2) | 0.716 |
CCRTx | 91 (34.2) | 44 (35.2) | 0.938 |
Surgical approach | |||
Lobectomy | 229 (86.1) | 121 (96.8) | 0.002 |
Bilobectomy | 20 (7.5) | 2 (1.6) | 0.033 |
Pneumonectomy | 17 (6.4) | 2 (1.6) | 0.071 |
Time variable | |||
Early (surgery from 2006 to 2012) | 104 (41.0) | 49 (39.2) | 0.823 |
Late (surgery from 2012 to 2019) | 157 (59.0) | 76 (60.8) | |
No. of metastatic LN stations | |||
2 | 133 (50.0) | 121 (96.8) | < 0.001 |
3 | 98 (36.8) | 4 (3.2) | |
4 | 30 (11.3) | 0 | |
5 | 5 (1.9) | 0 | |
Total No. of dissected LN | 30.3±12.5 | 28.8±10.6 | 0.203 |
Total No. of positive LN | 11.3±8.6 | 7.5±5.6 | < 0.001 |
Extranodal invasion of LN | |||
No | 223 (83.8) | 113 (90.4) | 0.113 |
Yes | 43 (16.2) | 12 (9.6) |
Univariate |
Multivariate |
|||
---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | |
Sex | ||||
Female | Reference | - | Reference | - |
Male | 1.42 (1.18-1.70) | < 0.001 | 1.41 (1.17-1.69) | < 0.001 |
Age (yr) | 1.03 (1.02-1.04) | < 0.001 | 1.02 (1.01-1.03) | < 0.001 |
8th pathologic node factor | ||||
N2a1 | Reference | - | Reference | - |
N2a2 | 1.24 (0.97-1.58) | 0.091 | 1.37 (1.07-1.76) | 0.013 |
N2b-sinlge zone | 1.24 (0.91-1.72) | 0.184 | 1.49 (1.08-2.08) | 0.017 |
N2b-multiple zone | 1.85 (1.43-2.38) | < 0.001 | 2.20 (1.69-2.85) | < 0.001 |
Histological structure | ||||
Adenocarcinoma | 0.81 (0.67-0.98) | 0.030 | - | - |
Others | Reference | - | - | - |
8th pathologic tumor factor | ||||
pT1 | Reference | - | Reference | - |
pT2 | 1.25 (1.00-1.57) | 0.05 | 1.17 (0.93-1.46) | 0.182 |
pT3 | 1.71 (1.31-2.24) | < 0.001 | 1.47 (1.12-1.92) | 0.006 |
pT4 | 1.91 (1.37-2.65) | < 0.001 | 1.63 (1.17-2.27) | 0.004 |
Adjuvant therapy | ||||
No | Reference | - | Reference | - |
Yes | 0.45 (0.36-0.56) | < 0.001 | 0.48 (0.38-0.60) | < 0.001 |
Time variable | ||||
Early (surgery from 2006 to 2012) | Reference | - | - | - |
Late (surgery from 2012 to 2019) | 0.85 (0.71-1.02) | 0.086 | - | - |
Values are presented as median (IQR) or number (%). ADC, adenocarcinoma; CCRTx, combination chemoradiotherapy; CTx, chemotherapy; IQR, interquartile range; LN, lymph node; pN, pathologic N; pT, pathologic T; RTx, radiotherapy; SqCC, squamous cell carcinoma.
Values are presented as number (%), median (IQR), or mean±SD. CCRTx, postoperative chemoradiotherapy; CTx, postoperative chemotherapy; IQR, interquartile range; LN, lymph node; pT, pathologic T; RTx, postoperative radiotherapy; SD, standard deviation.
CI, confidence interval; HR, hazard ratio; NSCLC, non–small-cell lung cancer; pT, pathologic T.