第8版肺癌N分期包括淋巴结转移的位置，但不包括单N和多N描述符。单N和多N状态是否对非小细胞肺癌患者的预后进行分层(NSCLC)？使用国家癌症数据库，我们分析了病理分期为 N1-2 NSCLC 的患者。 N描述符分为病理单N1（pSingle-N1）、病理多发N1（pMulti-N1）、pSingle-N2和pMulti-N2。使用Kaplan-Meier法和多变量Cox回归模型进行生存分析。在一般分析队列中，分别有24,531、22,256、8,528和21,949名NSCLC患者患有pSingle-N1、pMulti-N1、pSingle-N2和pMulti-N2 。 pMulti-N1 和 pMulti-N2 患者的生存期分别比 pSingle-N1 和 pSingle-N2 患者短（风险比 [HR]：N1 为 1.22，P < 0.0001，N2 为 1.39，P < 0.0001）。调整年龄、性别和组织学后，pSingle-N2 与 pMulti-N1 相比的 HR 为 1.05（P = 0.0031）。 pN1 患者根据转移淋巴结计数进行分类（1、2、3、4），显示各组之间的预后存在显着差异（P < 0.0001）。在敏感性分析队列（仅限于 R0 切除、肺叶切除或更多、生存 ≥ 30 天、≥ 10 个检查淋巴结，且未经新辅助治疗；n = 34,904）和外部验证队列（n = 708）分析支持这些结果。具有 1 个转移淋巴结的 NSCLC 患者，无论是在 N1 站还是 N2 站，比具有 1 个以上淋巴结受累的患者有更好的生存率。具有单个跳过 N2 淋巴结转移的 NSCLC 患者的生存率与具有多个 N1 淋巴结的患者相似，并且 N1 切除涉及的淋巴结数量达到 ≥ 4 个时具有连续性预后。版权所有 © 2024 美国胸科医师学会。由爱思唯尔公司出版。保留所有权利。

The 8th edition of lung cancer N staging assignment includes the location of lymph node metastasis, but does not include single- and multiple-N descriptors.Do the single- and multiple-N statuses stratify the prognosis of patients with non-small cell lung cancer (NSCLC)?Using the National Cancer Database, we analyzed patients with pathologically staged N1-2 NSCLC. N descriptors were classified into pathological single N1 (pSingle-N1), pathological multiple N1 (pMulti-N1), pSingle-N2, and pMulti-N2. Survival analysis was performed using Kaplan-Meier method and multivariate Cox regression models.In the general analysis cohort, 24,531, 22,256, 8,528, and 21,949 NSCLC patients had pSingle-N1, pMulti-N1, pSingle-N2, and pMulti-N2, respectively. Patients with pMulti-N1 and pMulti-N2 had a shorter survival than those with pSingle-N1 and pSingle-N2, respectively (hazard ratio [HR]: 1.22, P < 0.0001 for N1 and 1.39, P < 0.0001 for N2). After adjusting age, sex, and histology, the HR for pSingle-N2 compared with pMulti-N1 was 1.05 (P = 0.0031). Patients with pN1 were categorized by metastatic lymph node count (1, 2, 3, 4+), showing significant prognostic differences among groups (P < 0.0001). In the sensitivity analysis cohort (limited to R0 resection, lobectomy or more, survival ≥ 30 days, ≥ 10 examined lymph nodes, and without neoadjuvant therapy; n = 34,904) and the external validation cohort (n = 708) analyses supported these results.NSCLC patients with 1 metastatic lymph node, whether in N1 or N2 stations, had better survival than those with more than 1 lymph node involved. NSCLC patients with a single skip N2 lymph node metastasis had survival similar to patients with multiple N1 lymph nodes, and the number of lymph nodes involved in N1 resections up to ≥ 4 was sequentially prognostic.Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.