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Background <p>Surgery with systematic lymph node (LN) dissection remains the primary treatment for early-stage and locally advanced operable non–small-cell lung cancer (NSCLC). However, the effect of the log odds of negative lymph nodes/T stage (LONT) in NSCLC remains unclear. This study aims to evaluate the correlation between LONT and prognosis of stage I–III NSCLC patients who underwent resection.</p> Methods <p>Clinical data from patients who underwent NSCLC resection were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The log odds of negative LONT, defined as log(NLNs + 1)/T stage, was calculated for each patient. The nonlinear relationship between LONT and overall survival (OS) and lung cancer-specific survival (LCSS) was evaluated using the cubic spline smoothing technique and Cox regression. The optimal LONT cut-off point was determined using X-tile plots, and propensity score matching (PSM) was performed to minimize inter-group differences.</p> Results <p>LONT demonstrated a nonlinear positive relationship with both OS and LCSS. Based on X-tile plot-determined cut-off point of 0.60, participants were categorized into low (&lt; 0.60) and high (≥ 0.60) LONT subgroups. Both before and after PSM, the high LONT group exhibited significantly better OS and LCSS compared to the low LONT group (both <i>P</i> &lt; 0.001). Similar survival differences were observed in subgroup analyses based on lymph node status and TNM stage. LONT was an independent predictor of OS (HR: 0.78, 95% CI: 0.74–0.81, <i>P</i> &lt; 0.001) and LCSS (HR: 0.75, 95% CI: 0.71–0.78, <i>P</i> &lt; 0.001).</p> Conclusions <p>LONT is a novel robust prognostic factor that could complement TNM staging system. A higher LONT is associated with better survival in stage I–III NSCLC patients who received resection.</p>

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Log odds of negative lymph nodes/T stage as a novel predictor of post-resection outcome in non–small cell lung cancer patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月20日

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  • Liu Shao,
  • Haoyang Cao,
  • Hao Yang,
  • Dongmei Li

摘要

Background

Surgery with systematic lymph node (LN) dissection remains the primary treatment for early-stage and locally advanced operable non–small-cell lung cancer (NSCLC). However, the effect of the log odds of negative lymph nodes/T stage (LONT) in NSCLC remains unclear. This study aims to evaluate the correlation between LONT and prognosis of stage I–III NSCLC patients who underwent resection.

Methods

Clinical data from patients who underwent NSCLC resection were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The log odds of negative LONT, defined as log(NLNs + 1)/T stage, was calculated for each patient. The nonlinear relationship between LONT and overall survival (OS) and lung cancer-specific survival (LCSS) was evaluated using the cubic spline smoothing technique and Cox regression. The optimal LONT cut-off point was determined using X-tile plots, and propensity score matching (PSM) was performed to minimize inter-group differences.

Results

LONT demonstrated a nonlinear positive relationship with both OS and LCSS. Based on X-tile plot-determined cut-off point of 0.60, participants were categorized into low (< 0.60) and high (≥ 0.60) LONT subgroups. Both before and after PSM, the high LONT group exhibited significantly better OS and LCSS compared to the low LONT group (both P < 0.001). Similar survival differences were observed in subgroup analyses based on lymph node status and TNM stage. LONT was an independent predictor of OS (HR: 0.78, 95% CI: 0.74–0.81, P < 0.001) and LCSS (HR: 0.75, 95% CI: 0.71–0.78, P < 0.001).

Conclusions

LONT is a novel robust prognostic factor that could complement TNM staging system. A higher LONT is associated with better survival in stage I–III NSCLC patients who received resection.