Lymph node staging has prognostic significance for patients with non-small-cell lung cancer (NSCLC) that has metastasized to the chest (M1a), according to a study published in the Journal of Thoracic Cancer.1

Current tumor, nodal, and metastasis (TNM) staging for NSCLC categorizes patients with M1a disease as clinical stage IV, regardless of the patient’s nodal (N) status; the present study was conducted to determine whether N status affects the prognosis of patients with M1a NSCLC.

Researchers identified 39,731 patients with M1a NSCLC; patients were stratified by N status, and lung cancer-specific survival (LCSS) was evaluated.

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N status was an independent predictor of prognosis; patients without disease involvement of the lymph nodes had better LCSS than patients with N1 status; N1 status was also linked to a better prognostic outcome than N2 and N3.

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The authors conclude that N status is an independent prognosis tool, which may have clinical significance for patients with M1a NSCLC.


  1. Dai C, Ren Y, Xie D, et al. Does lymph node metastasis have a negative prognostic impact in patients with NSCLC and M1a disease? J Thorac Oncol. 2016 Aug 24. doi: 10.1016/j.jtho.2016.06.030 [Epub ahead of print]