WCLC 2025 - Posters & ePosters-P2.05.10 Prognostic Factors in IIB-IIIB Patients With Nodal Involvement Underwent Surgery for NSCLC

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This retrospective multicenter study analyzed prognostic factors in 318 non-small cell lung cancer (NSCLC) patients with nodal involvement (stages IIB-IIIB per the new 9th TNM classification) who underwent anatomical surgical resection and lymphadenectomy without neoadjuvant therapy. Patients were stratified into stage IIB (34%), IIIA (53%), and IIIB (13%) groups based on pathological T and N descriptors including the new N2a (single station) and N2b (multiple station) categories.<br /><br />Results showed that in stage IIB, an advanced pathological T (pT) stage significantly predicted worse overall survival (OS). For stage IIIA, spread through air spaces (STAS), having three resected N2 lymph node stations, and N2 metastatic nodes were associated with shorter disease-free survival (DFS), while lymphatic invasion predicted poorer OS. In stage IIIB, high-grade adenocarcinoma was linked to worse DFS, whereas undergoing pneumonectomy, squamous cell histology, advanced pT, pN2b involvement, and concurrent pN1 nodal disease negatively impacted OS.<br /><br />Overall, 42.5% of patients experienced recurrence, and 20.8% died during follow-up. The study highlights that distinct pathological factors differentially affect DFS and OS depending on precise tumor stage and nodal involvement, validating the clinical relevance of the new TNM nodal subclassifications. Identification of these stage-specific prognostic markers allows for better risk stratification to tailor post-surgical therapies and follow-up schedules accordingly.<br /><br />In conclusion, this work supports the prognostic utility of the updated 9th TNM lung cancer staging system by demonstrating specific factors adversely influencing survival within nodal subgroups and calls for individualized management strategies based on refined tumor characteristics.

Asset Subtitle

Marco Chiappetta

Meta Tag

Speaker Marco Chiappetta

Topic Pulmonology and Staging

Keywords

non-small cell lung cancer

NSCLC

9th TNM classification

nodal involvement

prognostic factors

surgical resection

lymphadenectomy

disease-free survival

overall survival

tumor staging