{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T08:52:08Z","timestamp":1768294328555,"version":"3.49.0"},"reference-count":41,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Accurate prediction of lymph node metastasis (LNM) is critical for selecting optimal surgical procedures in early\u2010stage lung adenocarcinoma (LUAD). This study aimed to develop nomograms for intraoperative prediction of LNM in clinical stage IA LUAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1227 patients with clinical stage IA LUADs on computed tomography (CT) were enrolled to construct and validate nomograms for predicting LNM (LNM nomogram) and mediastinal LNM (LNM\u2010N2 nomogram). Recurrence\u2010free survival (RFS) and overall survival (OS) were compared between limited mediastinal lymphadenectomy (LML) and systematic mediastinal lymphadenectomy (SML) in the high\u2010 and low\u2010risk groups for LNM\u2010N2, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three variables were incorporated into the LNM nomogram and the LNM\u2010N2 nomogram, including preoperative serum carcinoembryonic antigen (CEA) level, CT appearance, and tumor size. The LNM nomogram showed good discriminatory performance, with C\u2010indexes of 0.879 (95% CI, 0.847\u20130.911) and 0.880 (95% CI, 0.834\u20130.926) in the development and validation cohorts, respectively. The C\u2010indexes of the LNM\u2010N2 nomogram were 0.812 (95% CI, 0.766\u20130.858) and 0.822 (95% CI, 0.762\u20130.882) in the development and validation cohorts, respectively. LML and SML had similar survival outcomes among patients with low risk of LNM\u2010N2 (5\u2010year RFS, 88.1% vs. 89.5%, P<jats:italic>p<\/jats:italic>\u2009=\u20090.790; 5\u2010year OS, 96.0% vs. 93.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.370). However, for patients with high risk of LNM\u2010N2, LML was associated with worse survival (5\u2010year RFS, 64.0% vs. 77.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.036; 5\u2010year OS, 66.0% vs. 85.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.038).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We developed and validated nomograms to predict LNM and LNM\u2010N2 intraoperatively in patients with clinical stage IA LUAD on CT. These nomograms may help surgeons to select optimal surgical procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6115","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T12:15:20Z","timestamp":1684757720000},"page":"14360-14374","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Nomograms for intraoperative prediction of lymph node metastasis in clinical stage <scp>IA<\/scp> lung adenocarcinoma"],"prefix":"10.1002","volume":"12","author":[{"given":"Feng","family":"Li","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"},{"name":"Department of Thoracic Surgery The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-241X","authenticated-orcid":false,"given":"Yousheng","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,22]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"National Comprehensive Cancer Centers.NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Non\u2010Small Cell Lung Cancer (Version 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