{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:49:44Z","timestamp":1790912984124,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T00:00:00Z","timestamp":1578355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T00:00:00Z","timestamp":1578355200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T00:00:00Z","timestamp":1578355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the seventh edition TNM staging system for lung cancer, a high maximum standardized uptake value (SUVmax) on positron emission tomography was regarded as a risk factor for occult lymph node metastasis in clinical T1N0\u00a0non\u2010small cell lung cancer (NSCLC). However, in the eighth edition TNM classification, tumors are classified according to the size of the invasive component only, and those with invasive component size \u22643\u00a0cm are diagnosed as stage T1. The aim of this study was to reassess the risk factors for occult lymph node metastasis under the eighth edition TNM classification for lung cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2010 to 2017, 553 patients with clinical N0 peripheral NSCLC with invasive component size \u22643\u00a0cm underwent anatomical lobectomy with systematic lymph node dissection. We analyzed these cases retrospectively to identify risk factors for postoperative nodal upstaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 553 study patients, 54 (9.8%) had nodal upstaging after surgery. In multivariate analysis adopting the eighth edition TNM classification for lung cancer, serum carcinoembryonic antigen (CEA) level (hazard ratio [HR]\u2009=\u20091.113, <jats:italic>p\u2009<\/jats:italic>=\u20090.002), invasive component size (HR\u2009=\u20092.398, <jats:italic>p\u2009<\/jats:italic>=\u20090.004), visceral pleural invasion (HR\u2009=\u20092.901, <jats:italic>p\u2009<\/jats:italic>=\u20090.005), and lymphatic invasion (HR\u2009=\u20099.336, <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001) were significant risk factors for nodal upstaging, but SUVmax was not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SUVmax is not a predictor of nodal upstaging in clinical N0 peripheral NSCLC with invasive component size \u22643\u00a0cm under the eighth edition TNM classification for lung cancer. Significant risk factors of occult lymph node metastasis are serum CEA level, tumor invasive component size, visceral pleural invasion, and lymphatic invasion.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05365-5","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T15:03:33Z","timestamp":1578409413000},"page":"1658-1665","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Risk Factors for Occult Lymph Node Metastasis in Peripheral Non\u2010Small Cell Lung Cancer with Invasive Component Size 3\u00a0cm or Less"],"prefix":"10.1002","volume":"44","author":[{"given":"Youngkyu","family":"Moon","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Eunpyeong St. Mary's Hospital, College of Medicine The Catholic University of Korea 1021, Tongil\u2010ro, Eunpyeong\u2010gu 03312 Seoul Republic of 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