Related Experiment Video
Updated: May 20, 2026
Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
Published on: April 18, 2025
Distinct recurrence patterns related to preoperative treatment decisions for patients with locally advanced non-small
Kazuhiro Okada1, Ken Suzawa2,3, Tsuyoshi Ryuko1,4
1Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Purpose:
Locally advanced non-small cell lung cancer (LA-NSCLC) is a heterogeneous disease that requires tailored treatment strategies. This study investigates the correlation between T and N factors and postoperative recurrence patterns to refine therapeutic approaches.
Methods:
The subjects of this retrospective cohort study were 193 patients with LA-NSCLC, who underwent trimodality therapy between 1999 and 2021. Tumors were categorized as Nodal-Dominant (ND) LA-NSCLC (T1-2 with advanced nodal involvement) or Tumor-Dominant (TD) LA-NSCLC (T3-4 with limited nodal involvement). We compared recurrence patterns and survival outcomes between the two groups.
Results:
The 193 patients comprised 83 with ND-LA-NSCLC and 110 with TD-LA-NSCLC. The patients with ND-LA-NSCLC had a significantly higher rate of distant metastasis than those with TD-LA-NSCLC (50.6% vs. 26.4%, P = 0.001). The patients with TD-LA-NSCLC had significantly better 5-year disease-free survival (DFS) than those with ND-LA-NSCLC (62.4% vs. 37.2%, P < 0.001).
Conclusions:
ND-LA-NSCLC is associated with a higher risk of distant metastatic recurrence, underscoring the need for more effective systemic therapies before surgery. Conversely, TD-LA-NSCLC exhibits superior local disease control, reinforcing the role of intensive local therapies. These findings emphasize the importance of tumor classification based on T and N factors for optimizing perioperative treatment strategies for LA-NSCLC.