{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:27:17Z","timestamp":1791192437270,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,12,21]],"date-time":"2011-12-21T00:00:00Z","timestamp":1324425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["30801377"],"award-info":[{"award-number":["30801377"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006606","name":"Natural Science Foundation of Tianjin Municipality","doi-asserted-by":"publisher","award":["11JCYBJC13300"],"award-info":[{"award-number":["11JCYBJC13300"]}],"id":[{"id":"10.13039\/501100006606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013286","name":"Specialized Research Fund for the Doctoral Program of Higher Education of China","doi-asserted-by":"publisher","award":["20101202120004"],"award-info":[{"award-number":["20101202120004"]}],"id":[{"id":"10.13039\/501100013286","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to investigate the relation between the metastatic lymph node ratio (LNR) and the prognosis of non\u2010small\u2010cell lung cancer (NSCLC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 301 patients with N1 or N2\u00a0NSCLC who underwent complete pulmonary resection were analyzed retrospectively. The correlations between the LNR and clinical and pathologic data were analyzed using \u03c7<jats:sup>2<\/jats:sup> test analysis. The prognostic value of the LNR was calculated by univariate Kaplan\u2013Meier survival analysis and multivariate Cox proportional hazard model analysis. The risk groups were classified by a combination of the LNR and pN stage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The LNR was correlated with age, smoking status, pathologic type, subcarinal lymph node, clinical staging, N stage (<jats:italic>P<\/jats:italic> &lt; 0.05), and the number of positive lymph nodes and positive lymph node stations (<jats:italic>P<\/jats:italic> &lt; 0.0001). In the univariate analysis, the LNR played an important role in predicting overall survival (OS) (<jats:italic>P<\/jats:italic> &lt; 0.0001) and disease\u2010free survival (<jats:italic>P<\/jats:italic> &lt; 0.0001) by Kaplan\u2013Meier survival analysis. In the multivariate analysis, high LNR (&gt;18%) was an independent poor prognostic factor for OS [hazard ratio (HR) 2.5034, 95% confidence interval (CI) 1.6096\u20133.8933, <jats:italic>P<\/jats:italic> &lt; 0.0001] and DFS (HR 1.9023, 95% CI 1.2465\u20132.9031, <jats:italic>P<\/jats:italic> = 0.0031). Stratification into high\u2010, medium\u2010, and low\u2010risk groups\u2014based on high\u2010risk factors (LNR &gt; 18%, N2) intermediate\u2010risk factors (LNR &gt; 18%, N1 or LNR &lt; 18%, N2), and low\u2010risk factors (LNR &lt; 18%, N1)\u2014could efficiently predicted outcomes (<jats:italic>P<\/jats:italic> &lt; 0.0001) of patients with lymph node\u2010positive NSCLC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of the LNR and pN status provides a valuable help with prognosis. However, these results must be evaluated further in a large prospective randomized clinical trial.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-011-1360-8","type":"journal-article","created":{"date-parts":[[2011,12,20]],"date-time":"2011-12-20T20:05:47Z","timestamp":1324411547000},"page":"455-462","source":"Crossref","is-referenced-by-count":38,"title":["Value of the Metastatic Lymph Node Ratio for Predicting the Prognosis of Non\u2010Small\u2010Cell Lung Cancer Patients"],"prefix":"10.1002","volume":"36","author":[{"given":"Chang\u2010Li","family":"Wang","sequence":"first","affiliation":[{"name":"Key Laboratory of Cancer Prevention and Therapy of Tianjin, Department of Lung Cancer Surgery, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital Tianjin Medical University 300060 Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory of Cancer Prevention and Therapy of Tianjin, Department of Lung Cancer Surgery, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital Tianjin Medical University 300060 Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong\u2010Sheng","family":"Yue","sequence":"additional","affiliation":[{"name":"Key Laboratory of Cancer Prevention and Therapy of Tianjin, Department of Lung Cancer Surgery, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital Tianjin Medical University 300060 Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian\u2010Min","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Cancer Prevention and Therapy of Tianjin, Department of Lung Cancer Surgery, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital Tianjin Medical University 300060 Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen\u2010Fa","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Cancer Prevention and Therapy of Tianjin, Department of Lung Cancer Surgery, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital Tianjin Medical University 300060 Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing\u2010Sheng","family":"Sun","sequence":"additional","affiliation":[{"name":"Key Laboratory of Cancer Prevention and Therapy of Tianjin, Department of Lung Cancer Surgery, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital Tianjin Medical University 300060 Tianjin 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