{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:55:36Z","timestamp":1792014936865,"version":"4.4.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The role of upfront surgery in treating stage IIIA-N2 non-small cell lung cancer remains controversial. This study aimed to evaluate the role of upfront surgery in selected patients with stage IIIA-N2 and assess the prognostic significance of the number of involved lymph node zones in relation to the N2-subclassification proposed by the International Association for the Study of Lung Cancer, comparing adenocarcinoma and squamous cell carcinoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We retrospectively analysed patients with pIIIA-N2 adeno- or squamous cell carcinoma who underwent complete surgical resection with zone-based lymph node dissection. Survival was calculated using the Kaplan\u2013Meier method, and group differences were assessed via log-rank test and Cox regression analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 222 patients were analysed. The 5-year overall survival rate was 43%, with a median overall survival of 47.2\u2009months. In the adenocarcinoma cohort, the N2b-subgroup was associated with a 1.7-fold increased risk of death, whereas adjuvant chemotherapy reduced the risk by 41%. In squamous cell carcinoma, neither adjuvant chemotherapy nor the N2b-subgroup were identified as prognostic factors for overall survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The zone concept for intraoperatively assigning lymph nodes and the proposed N2-subgroups allowed a good stratification of long-term survival in patients with adenocarcinoma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf121","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T18:05:04Z","timestamp":1748369104000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of the number of involved lymph node zones on survival in stage IIIA-N2 lung adeno and squamous cell carcinoma"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2080-4606","authenticated-orcid":false,"given":"Raffaella","family":"Griffo","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]},{"name":"Division of Thoracic Surgery, University Hospital Rechts der Isar, Technical University of Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyer","family":"Safi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, University Hospital Rechts der Isar, Technical University of Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Eichhorn","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]},{"name":"Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL) , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura V","family":"Klotz","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]},{"name":"Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL) , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Muley","sequence":"additional","affiliation":[{"name":"Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL) , Heidelberg,","place":["Germany"]},{"name":"Translational Research Unit, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Baum","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Kriegsmann","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]},{"name":"Department of Pathology, University of Heidelberg , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Bischoff","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hauke","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]},{"name":"Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL) , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0362-0374","authenticated-orcid":false,"given":"Martin E","family":"Eichhorn","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg , Heidelberg,","place":["Germany"]},{"name":"Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL) , 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