{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:14:43Z","timestamp":1767176083995,"version":"build-2238731810"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The authors aimed to create a novel model to predict lymphatic metastasis in thymic epithelial tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data of 1018 patients were collected from the Surveillance, Epidemiology, and End Results database from 2004 to 2015. To construct a nomogram, the least absolute shrinkage and selection operator (LASSO) regression model  was\u00a0used to select candidate features of the training cohort from 2004 to 2013. A simple model called the Lymphatic Node Metastasis Risk Scoring System (LNMRS) was constructed to predict lymphatic metastasis. Using patients from 2014 to 2015 as the validation cohort, the predictive performance of the model was determined by receiver operating characteristic (ROC) curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The LASSO regression model showed that age, extension, and histology type were significantly associated with lymph node metastasis, which were used to construct the nomogram. Through analysis of the area under the curve (AUC), the nomogram achieved a AUC value of 0.80 (95 % confidence interval [Cl] 0.75\u20130.85) in the training cohort and 0.82 (95 % Cl 0.70\u20130.93) in the validation cohort, and had closed calibration curves. Based on the nomogram, the authors constructed the LNMRS model, which had an AUC of 0.80 (95 % Cl 0.75\u20130.85) in the training cohort and 0.82 (95% Cl 0.70\u20130.93) in the validation cohort. The ROC curves indicated that the LNMRS had excellent predictive performance for lymph node metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study established a nomogram for predicting lymph node metastasis. The LNMRS model, constructed to predict lymphatic involvement of patients, was more convenient than the nomogram.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-021-10602-0","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T10:05:49Z","timestamp":1630058749000},"page":"598-605","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lymphatic Node Metastasis Risk Scoring System: A Novel Instrument for Predicting Lymph Node Metastasis After Thymic Epithelial Tumor Resection"],"prefix":"10.1245","volume":"29","author":[{"given":"Xinxin","family":"Cheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaxin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weilin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianyong","family":"Zou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenguang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"key":"10602_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/S0003-4975(10)62059-0","volume":"44","author":"RD Davis","year":"1987","unstructured":"Davis RD, Oldham HN, Sabiston DC. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Ann Thorac Surg. 1987;44:229\u201337.","journal-title":"Ann Thorac Surg."},{"key":"10602_CR2","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1016\/j.jtcvs.2018.04.049","volume":"156","author":"W Fang","year":"2018","unstructured":"Fang W, Wang Y, Pang L, Gu Z, Wei Y, Liu Y, et al. Members of the Chinese Alliance for Research in T lymph node metastasis in thymic malignancies: a Chinese multicenter prospective observational study. J Thorac Cardiovasc Surg. 2018;156:824-33 e1.","journal-title":"J Thorac Cardiovasc Surg."},{"key":"10602_CR3","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1016\/S0003-4975(03)01017-8","volume":"76","author":"K Kondo","year":"2003","unstructured":"Kondo K, Monden Y. Lymphogenous and hematogenous metastasis of thymic epithelial tumors. Ann Thorac Surg. 2003;76:1859\u201364.","journal-title":"Ann Thorac Surg."},{"key":"10602_CR4","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1097\/JTO.0b013e31819cce50","volume":"4","author":"S Watanabe","year":"2009","unstructured":"Watanabe S, Asamura H. Lymph node dissection for lung cancer: significance, strategy, and technique. J Thorac Oncol. 2009;4:652\u20137.","journal-title":"J Thorac Oncol."},{"key":"10602_CR5","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1016\/j.athoracsur.2012.05.034","volume":"94","author":"RJ Cerfolio","year":"2012","unstructured":"Cerfolio RJ, Bryant AS, Minnich DJ. Complete thoracic mediastinal lymphadenectomy leads to a higher rate of pathologically proven N2 disease in patients with non-small cell lung cancer. Ann Thorac Surg. 2012;94:902\u20136.","journal-title":"Ann Thorac Surg."},{"key":"10602_CR6","doi-asserted-by":"publisher","first-page":"e8356","DOI":"10.1097\/MD.0000000000008356","volume":"96","author":"Y Shen-Tu","year":"2017","unstructured":"Shen-Tu Y, Mao F, Pan Y, Wang W, Zhang L, Zhang H, et al. Lymph node dissection and survival in patients with early-stage non-small cell lung cancer: a 10-year cohort study. Med Baltimore. 2017;96:e8356.","journal-title":"Med Baltimore."},{"key":"10602_CR7","doi-asserted-by":"publisher","first-page":"e2054","DOI":"10.1097\/MD.0000000000002054","volume":"94","author":"L Jiang","year":"2015","unstructured":"Jiang L, Jiang S, Lin Y, Yang H, Xie Z, Lin Y, Long H. Nomogram to predict occult N2 lymph nodes metastases in patients with squamous nonsmall cell lung cancer. Med Baltimore. 2015;94:e2054.","journal-title":"Med. Baltimore."},{"key":"10602_CR8","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.4143\/crt.2018.569","volume":"51","author":"JR Oh","year":"2019","unstructured":"Oh JR, Park B, Lee S, Han KS, Youk EG, Lee DH, et al. Nomogram development and external validation for predicting the risk of lymph node metastasis in T1 colorectal cancer. Cancer Res Treat. 2019;51:1275\u201384.","journal-title":"Cancer Res Treat."},{"key":"10602_CR9","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1002\/bjs.10882","volume":"105","author":"H Zheng","year":"2018","unstructured":"Zheng H, Tang H, Wang H, Fang Y, Shen Y, Feng M, et al. Nomogram to predict lymph node metastasis in patients with early oesophageal squamous cell carcinoma. Br J Surg. 2018;105:1464\u201370.","journal-title":"Br J Surg."},{"issue":"10 Suppl 4","key":"10602_CR10","doi-asserted-by":"publisher","first-page":"S260","DOI":"10.1097\/JTO.0b013e3181f1f62d","volume":"5","author":"EA Engels","year":"2010","unstructured":"Engels EA. Epidemiology of thymoma and associated malignancies. J Thorac Oncol. 2010;5(10 Suppl 4):S260\u20135.","journal-title":"J Thorac Oncol."},{"key":"10602_CR11","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1016\/j.ejca.2012.02.047","volume":"48","author":"S Siesling","year":"2012","unstructured":"Siesling S, van der Zwan JM, Izarzugaza I, Jaal J, Treasure T, Foschi R, et al. Rare thoracic cancers, including peritoneum mesothelioma. Eur J Cancer. 2012;48:949\u201360.","journal-title":"Eur J Cancer."},{"key":"10602_CR12","doi-asserted-by":"crossref","unstructured":"Detterbeck FC, Stratton K, Giroux D, Asamura H, Crowley J, Falkson C, et al. The IASLC\/ITMIG Thymic Epithelial Tumors Staging Project: proposal for an evidence-based stage classification system for the forthcoming 8th edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9(9 Suppl 2):S65\u201372.","DOI":"10.1097\/JTO.0000000000000290"},{"key":"10602_CR13","doi-asserted-by":"crossref","unstructured":"Bhora FY, Chen DJ, Detterbeck FC, Asamura H, Falkson C, Filosso PL, et al. The ITMIG\/IASLC Thymic Epithelial Tumors Staging Project: a proposed lymph node map for thymic epithelial tumors in the forthcoming 8th edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9(9 Suppl 2):S88\u201396.","DOI":"10.1097\/JTO.0000000000000293"},{"key":"10602_CR14","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1097\/JTO.0000000000000654","volume":"10","author":"A Marx","year":"2015","unstructured":"Marx A, Chan JK, Coindre JM, Detterbeck F, Girard N, Harris NL, et al. The 2015 World Health Organization classification of tumors of the thymus: continuity and changes. J Thorac Oncol. 2015;10:1383\u201395.","journal-title":"J Thorac Oncol."},{"key":"10602_CR15","unstructured":"SEER Summary Stage 2018: Summary Stage Manual 2000. Available from: https:\/\/seer.cancer.gov\/tools\/ssm\/SSM2018-RESPIRATORY-TRACT-AND-THORAX.pdf."},{"key":"10602_CR16","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.ejrad.2006.05.003","volume":"60","author":"J Sadohara","year":"2006","unstructured":"Sadohara J, Fujimoto K, Muller NL, Kato S, Takamori S, Ohkuma K, et al. Thymic epithelial tumors: comparison of CT and MR imaging findings of low-risk thymomas, high-risk thymomas, and thymic carcinomas. Eur J Radiol. 2006;60:70\u20139.","journal-title":"Eur J Radiol."},{"key":"10602_CR17","unstructured":"Hastie T, Efron B. lars: Least Angle Regression, Lasso and Forward Stagewise. 2013.R package version 1.2. https:\/\/CRAN.R-project.org\/package=lars."},{"key":"10602_CR18","unstructured":"EF H Jr. rms: Regression Modeling Strategies. 2020.R package version 6.2-0. https:\/\/CRAN.R-project.org\/package=rms."},{"key":"10602_CR19","unstructured":"Team, R. C., R: A Language and Environment for Statistical Computing. 2019. R Foundation for Statistical Computing, Vienna, Austria. https:\/\/www.R-project.org\/."},{"key":"10602_CR20","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/j.jtcvs.2014.11.054","volume":"149","author":"B Weksler","year":"2015","unstructured":"Weksler B, Pennathur A, Sullivan JL, Nason KS. Resection of thymoma should include nodal sampling. J Thorac Cardiovasc Surg. 2015;149:737\u201342.","journal-title":"J Thorac Cardiovasc Surg."},{"key":"10602_CR21","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1097\/JTO.0000000000000660","volume":"10","author":"B Weksler","year":"2015","unstructured":"Weksler B, Holden A, Sullivan JL. Impact of positive nodal metastases in patients with thymic carcinoma and thymic neuroendocrine tumors. J Thorac Oncol. 2015;10:1642\u20137.","journal-title":"J Thorac Oncol."},{"key":"10602_CR22","doi-asserted-by":"publisher","first-page":"1949","DOI":"10.1016\/j.jtho.2018.08.2026","volume":"13","author":"Y Hwang","year":"2018","unstructured":"Hwang Y, Kang CH, Park S, Lee HJ, Park IK, Kim YT, et al. Impact of lymph node dissection on thymic malignancies: multi-institutional propensity score-matched analysis. J Thorac Oncol. 2018;13:1949\u201357.","journal-title":"J Thorac Oncol."},{"key":"10602_CR23","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1093\/icvts\/ivx116","volume":"25","author":"Z Gu","year":"2017","unstructured":"Gu Z, Wei Y, Fu J, Tan L, Zhang P, Han Y, et al. Members of the Chinese Alliance for Research in T lymph node metastases in thymic malignancies: a Chinese Alliance for Research in Thymomas retrospective database analysis. Interact Cardiovasc Thorac Surg. 2017;25:455\u201361.","journal-title":"Interact Cardiovasc Thorac Surg."},{"key":"10602_CR24","unstructured":"NCCN, NCCN Clinical Practice Guidelines in Oncology Thymomas and Thymic Carcinomas. 2020. https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1469"},{"key":"10602_CR25","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1055\/s-0043-122379","volume":"50","author":"SK Pokala","year":"2018","unstructured":"Pokala SK, Zhang C, Chen Z, Gamboa AM, Cristofaro SL, Keilin SA, et al. Lymph node metastasis in early gastric adenocarcinoma in the United States of America. Endoscopy. 2018;50:479\u201386.","journal-title":"Endoscopy."},{"key":"10602_CR26","doi-asserted-by":"publisher","unstructured":"Zhang X-F, Xue F, Dong D-H, Weiss M, Popescu I, Marques HP, et al. Number and station of lymph node metastasis after curative-intent resection of intrahepatic cholangiocarcinoma: impact prognosis. Ann. Surg. 2020. https:\/\/doi.org\/10.1097\/SLA.0000000000003788","DOI":"10.1097\/SLA.0000000000003788"},{"key":"10602_CR27","doi-asserted-by":"crossref","unstructured":"Choi AH, Nelson RA, Merchant SJ, Kim JY, Chao J, Kim J. Rates of lymph node metastasis and survival in T1a gastric adenocarcinoma in Western populations. Gastrointest Endosc. 2016;83:1184\u201392.","DOI":"10.1016\/j.gie.2015.10.039"}],"updated-by":[{"DOI":"10.1245\/s10434-021-11080-0","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T00:00:00Z","timestamp":1636675200000}}],"container-title":["Annals of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-021-10602-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1245\/s10434-021-10602-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-021-10602-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T13:12:45Z","timestamp":1639660365000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1245\/s10434-021-10602-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,27]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10602"],"URL":"https:\/\/doi.org\/10.1245\/s10434-021-10602-0","relation":{},"ISSN":["1068-9265","1534-4681"],"issn-type":[{"value":"1068-9265","type":"print"},{"value":"1534-4681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,27]]},"assertion":[{"value":"6 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2021","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1245\/s10434-021-11080-0","URL":"https:\/\/doi.org\/10.1245\/s10434-021-11080-0","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}}]}}