{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:21:09Z","timestamp":1781155269399,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82472994"],"award-info":[{"award-number":["82472994"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82541024"],"award-info":[{"award-number":["82541024"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["3332024216"],"award-info":[{"award-number":["3332024216"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The tumor and node metastasis (TNM) staging and pathological grading systems are currently insufficient for accurately predicting recurrence\u2010free survival (RFS) in patients with pathological stage (p\u2010stage) I lung adenocarcinoma (LUAD). Therefore, there is an urgent need for a more economical and applicable clinical prediction model to assess the risk of recurrence and guide clinical postoperative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 544 patients with p\u2010stage I LUAD who were randomly allocated to development (272 patients) and validation (272 patients) cohorts. Cox regression and backward model selection were used to develop the prediction model. The predictive performance of the model was then compared with that of the current TNM staging system and two major pathological grading systems. The primary endpoint was RFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 79 out of 544 patients with p\u2010stage I LUAD experienced recurrence after surgery. Four risk factors were incorporated into a weighted risk index\u2014high\u2010grade patterns ratio, epidermal growth factor receptor mutation status, spread through air spaces status and consolidation tumor ratio\u2014to establish the \u201cCEHS\u201d RFS prediction model. This model demonstrated superior predictive accuracy compared with existing staging and grading systems. High\u2010risk patients had significantly shorter RFS than low\u2010risk patients did. An online algorithm based on the CEHS model was also developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We established and validated a novel model that integrates radiological, molecular and pathological features to predict RFS in patients with p\u2010stage I LUAD. This new model exhibited excellent discriminatory power for classifying early\u2010stage LUAD patients at different risks of recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1759-7714.70291","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T13:55:52Z","timestamp":1776952552000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Radiological, Molecular, and Pathological Factors Unite: A Model for Predicting Recurrence\u2010Free Survival in Pathological Stage I Lung Adenocarcinoma"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2076-7458","authenticated-orcid":false,"given":"Hui","family":"Zeng","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 Immunology and National Key Laboratory of Medical Molecular Biology Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College  Beijing China"},{"name":"Department of Oral and Maxillofacial\u2010Head and Neck Oncology, Ninth People's Hospital Shanghai Jiao Tong University, School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufei","family":"Huang","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehao","family":"Song","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenlong","family":"Yuan","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyu","family":"Ren","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":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7628-0797","authenticated-orcid":false,"given":"Jiaxi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Thoracic 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