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. 2026 Mar 28;40(8):893–902. doi: 10.1007/s12149-026-02198-w

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© The Author(s) 2026

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 4 — Survival Impact of Down-staging from IIB to IIA in TNM 9. The top panel shows the distribution of stage migration from TNM 8 to TNM 9, highlighting cases that were down-staged or up-staged. The bottom panel presents Kaplan-Meier survival curves comparing OS between patients whose stage remained unchanged in IIA and those who were down-staged from IIB to IIA. Stage IIA (left graph): Down-staged patients had a higher OS compared to patients whose stage remained unchanged in IIA, but this was not statistically significant (p = 0.56). The 5-year OS was 88% down-staged group and 75% was an unchanged group. Stage IIB (right graph): Down-staged patients also had better survival, but again, the difference was not statistically significant (p = 0.19). The 5-year OS was 88% down-staged group and 61% was unchanged group