{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T04:19:03Z","timestamp":1769919543968,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aimed to investigate the presentations and survival outcomes of the distant metastatic non\u2010small cell lung cancer (NSCLC) without lymph node involvement to obtain a clearer picture of this special subgroup of metastatic NSCLC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A least absolute shrinkage and selection operator (LASSO) penalized Cox regression analysis was used to select the prognostic variables. A nomogram and corresponding risk\u2010classifying systems were constructed. The C\u2010index and calibration curves were used to evaluate the performance of the model. Overall survival (OS) curves were plotted using the Kaplan\u2013Meier method, and the log\u2010rank test was used to compare OS differences between groups. Propensity score matching (PSM) was performed to reduce bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 12\u2009610 NSCLC patients with M1 category (N0 group: 3045 cases; N1\u20103 group: 9565 cases) were included. Regarding the N0 group, multivariate analysis demonstrated that age, sex, race, surgery, grade, tumor size, and M category were independent prognostic factors. A nomogram and corresponding risk\u2010classifying systems were formulated. Favorable validation results were obtained from the C\u2010index, calibration curves, and survival comparisons. Survival curves demonstrated that N0 NSCLC patients had better survival than N1\u20103 NSCLC patients both before and after PSM. Furthermore, the survival of resected N0M1 patients was superior to that of those without surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, a prognostic nomogram and risk\u2010classifying systems designed for the T1\u20104N0M1 NSCLC patients showed acceptable performance. Primary lung tumor resection might be a feasible treatment for this population subset. Additionally, we proposed that lymph node stage might have a place in the forthcoming tumor\u2010node\u2010metastasis (TNM)\u00a0staging proposal for NSCLC patients with M1 category.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13668","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T04:56:12Z","timestamp":1690260972000},"page":"780-790","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigations of the distant metastatic non\u2010small cell lung cancer without local lymph node involvement: Real world data from a large database"],"prefix":"10.1111","volume":"17","author":[{"given":"Bao\u2010Wen","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Sun Yat\u2010sen University Cancer Center  Guangzhou China"},{"name":"State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010sen 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