{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:38:02Z","timestamp":1767713882621,"version":"3.41.2"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract and keywords<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To assess the prognostic impact of adequate lymphadenectomy and determine the optimal nodal assessment for different clinical stages of lung cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We retrospectively reviewed 1214 patients with clinical stage I\u2013III non-small cell lung cancer who had preoperative PET\/CT and curative surgery (2006\u20132017). Patients were categorized based on whether they had adequate [R0] or inadequate lymphadenectomy [R(un)]. Propensity score matching was conducted to minimize bias. Primary end-points were recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival (CSS). Secondary end-points included outcomes stratified by clinical stages.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Multivariate Cox analysis identified preoperative carcinoembryonic antigen level, tumour size, uptake of tumour on PET\/CT, R(un) (Hazard ratio (HR)= 2.16; p\u2009&amp;lt;\u20090.001), angiolymphatic invasion, lymph node involvement, and postoperative adjuvant therapy as independent predictors of RFS. The matched cohort included 440 R0 and 440 R(un) patients, with a median follow-up of 94\u2009months. Significant differences were found in 10-year RFS (77.2% vs 61.3%, p\u2009&amp;lt;\u20090.001), OS (75.8% vs 64.3%, p\u2009&amp;lt;\u20090.001) and CSS (83.8% vs 74.2%, p\u2009&amp;lt;\u20090.001). Despite longer operative time for R0 (210 vs 195\u2009min, p\u2009=\u20090.008), perioperative complications, hospital stay length, and blood loss were similar. Subgroup analysis showed R(un) as an independent predictor of RFS in clinical stages IA3 (HR\u2009=\u20092.53, p\u2009=\u20090.001), IB (HR\u2009=\u20091.71, p\u2009=\u20090.046), and II (HR\u2009=\u20092.44, p\u2009&amp;lt;\u20090.001), but not in IA1 or IA2. R0 had significantly better RFS than R(un) in matched cohort of stages IA3 (p\u2009=\u20090.003), IB (p\u2009=\u20090.001), and II (p\u2009=\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Adequate lymph node assessment improves prognosis in patients with clinical stages \u2265 IA3. A uniform nodal assessment approach should be reconsidered for different clinical stages.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf083","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T18:53:06Z","timestamp":1741805586000},"source":"Crossref","is-referenced-by-count":3,"title":["Clinical stage-specific prognostic impact of adequate lymphadenectomy in early-stage lung cancer"],"prefix":"10.1093","author":[{"given":"Chia","family":"Liu","sequence":"first","affiliation":[{"name":"Taipei Veterans General Hospital Division of Thoracic Surgery, Department of Surgery, , ; Taipei City,","place":["Taiwan"]},{"name":"National Yang Ming Chiao Tung University School of Medicine, , Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ko-Han","family":"Lin","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital Department of Nuclear Medicine, , ; Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui-Mei","family":"Chen","sequence":"additional","affiliation":[{"name":"National Taipei University of Nursing and Health Sciences School of Nursing, College of Nursing, , Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei-Chi","family":"Wang","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital Department of Pathology, , Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Chen","family":"Yeh","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital Department of Pathology, , Taipei City,","place":["Taiwan"]},{"name":"National Yang Ming Chiao Tung University School of Medicine, , Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Kuei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital Division of Thoracic Surgery, Department of Surgery, , ; Taipei City,","place":["Taiwan"]},{"name":"National Yang Ming Chiao Tung University School of Medicine, , Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Sheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital Division of Thoracic Surgery, Department of Surgery, , ; Taipei City,","place":["Taiwan"]},{"name":"National Yang Ming Chiao Tung University School of Medicine, , Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Cheng","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital Division of Thoracic Surgery, Department of Surgery, , ; Taipei City,","place":["Taiwan"]},{"name":"National Yang Ming Chiao Tung University School of Medicine, , Taipei City,","place":["Taiwan"]},{"name":"New Taipei City Hospital Department of Surgery, , New Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han-Shui","family":"Hsu","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital Division of Thoracic Surgery, Department of Surgery, , ; Taipei City,","place":["Taiwan"]},{"name":"National Yang Ming Chiao Tung University School of Medicine, , Taipei City,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,12]]},"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezaf083\/62387337\/ezaf083.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezaf083\/62387337\/ezaf083.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T18:53:06Z","timestamp":1741805586000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article\/doi\/10.1093\/ejcts\/ezaf083\/8071867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,12]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezaf083","relation":{},"ISSN":["1873-734X"],"issn-type":[{"type":"electronic","value":"1873-734X"}],"subject":[],"published":{"date-parts":[[2025,3,12]]},"article-number":"ezaf083"}}