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Optimal cutoffs for lymph node parameters (NPLN, LNR, LODDS) were determined using X-tile software. Composite variables (N-NPLN, N-LNR, N-LODDS) were constructed by integrating N staging. Independent prognostic factors were screened via Cox regression, and a nomogram was developed. Performance was assessed using the receiver operating characteristic curves, calibration curves, and decision curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      N-LODDS staging demonstrated optimal prognostic prediction, significantly outperforming N-LNR and N-NPLN. The nomogram incorporating N-LODDS, tumor size, and nine independent prognostic factors showed superior discrimination and calibration (5\u00a0year area under the curve 0.740; 95% confidence interval 0.731\u20130.749) in both training and validation cohorts, with significant advantages over the TNM staging system (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The N-LODDS staging system significantly improves prognostic accuracy by integrating anatomical and quantitative lymph node features, providing a novel tool for personalized NSCLC management. Future multicenter prospective studies are needed to validate its clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-025-19005-x","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T19:36:51Z","timestamp":1768937811000},"page":"4242-4255","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["N-LODDS: A Novel Integrated Lymph Node Staging System Enhancing Prognostic Accuracy in Non-Small-Cell Lung Cancer"],"prefix":"10.1245","volume":"33","author":[{"given":"Qiying","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meihong","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zishan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiwen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinman","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binghua","family":"Tu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyue","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinghong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"3","key":"19005_CR1","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, et al. 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