Table 2. Survival comparisons of the AJCC 8th pN versus LNR stages and the AJCC 8th TNM versus TLNR classifications in the training and validation cohorts.
| Outcomes | HR (95% CI) | 5-Y OS or DFS, % (95% CI) |
|---|---|---|
| Training cohort (overall survival) (N=62,294) | ||
| AJCC 8th pN stage | ||
| pN0 (n=37,998) | 1.00 (reference) | 74.6 (74.2–75.0) |
| pN1a (n=7,694) | 1.27 (1.22–1.32) | 66.8 (65.7–67.8) |
| pN1b/1c (n=7,705) | 1.48 (1.43–1.54) | 61.0 (59.9–62.1) |
| pN2a (n=4,988) | 1.88 (1.81–1.96) | 52.7 (51.3–54.1) |
| pN2b (n=3,909) | 2.72 (2.61–2.84) | 39.8 (38.3–41.3) |
| LNR stage | ||
| LNR1 (n=40,576) | 1.00 (reference) | 74.5 (74.1–75.0) |
| LNR2 (n=14,725) | 1.45 (1.40–1.49) | 62.4 (61.6–63.1) |
| LNR3 (n=3,939) | 2.13 (2.04–2.22) | 48.6 (47.0–50.1) |
| LNR4 (n=1,516) | 2.61 (2.45–2.78) | 40.6 (38.1–43.0) |
| LNR5 (n=1,538) | 3.96 (3.74–4.20) | 26.9 (24.7–29.2) |
| AJCC 8th TNM classification | ||
| I (n=13,828) | 1.00 (reference) | 80.5 (79.8–81.1) |
| IIA (n=21,102) | 1.33 (1.28–1.38) | 73.1 (72.5–73.7) |
| IIB (n=1,708) | 2.02 (1.88–2.17) | 60.3 (57.9–62.5) |
| IIC (n=1,360) | 2.28 (2.11–2.46) | 55.3 (52.6–57.9) |
| IIIA (n=2,384) | 1.04 (0.97–1.13) | 78.0 (76.2–79.6) |
| IIIB (n=16,270) | 1.86 (1.79–1.93) | 61.5 (60.7–62.2) |
| IIIC (n=5,642) | 3.56 (3.41–3.72) | 38.3 (37.0–39.5) |
| TLNR classification | ||
| I (n=5,794) | 1.00 (reference) | 83.1 (82.1–84.1) |
| IIA (n=33,402) | 1.48 (1.41–1.56) | 75.0 (74.5–75.4) |
| IIB (n=12,746) | 2.13 (2.01–2.25) | 63.2 (62.3–64.0) |
| IIC (n=6,894) | 3.07 (2.90–3.26) | 49.7 (48.5–50.9) |
| IIIA (n=2,517) | 4.87 (4.55–5.21) | 33.6 (31.7–35.4) |
| IIIB (n=754) | 6.96 (6.34–7.63) | 22.2 (19.3–25.3) |
| IIIC (n=187) | 9.70 (8.24–11.4) | 13.4 (8.90–18.8) |
| Validation cohort (overall survival) (N=3,327) | ||
| AJCC 8th pN stage | ||
| pN0 (n=1,298) | 1.00 (reference) | 81.0 (78.4–83.2) |
| pN1a (n=723) | 1.38 (1.13–1.70) | 79.6 (75.8–82.8) |
| pN1b/1c (n=709) | 1.78 (1.47–2.16) | 73.6 (69.3–77.4) |
| pN2a (n=345) | 2.09 (1.65–2.65) | 71.5 (65.1–77.0) |
| pN2b (n=252) | 3.76 (3.01–4.71) | 52.1 (44.0–59.5) |
| LNR stage | ||
| LNR1 (n=1,513) | 1.00 (reference) | 80.9 (78.6–83.1) |
| LNR2 (n=1,308) | 1.48 (1.26–1.74) | 76.8 (73.8–79.5) |
| LNR3 (n=285) | 2.20 (1.74–2.80) | 66.4 (58.8–72.9) |
| LNR4 (n=93) | 3.21 (2.31–4.47) | 54.9 (41.6–66.3) |
| LNR5 (n=128) | 4.95 (3.84–6.38) | 44.0 (34.2–53.4) |
| AJCC 8th TNM classification | ||
| I (n=26) | 1.00 (reference) | 90.9 (50.8–98.7) |
| IIA (n=520) | 1.78 (0.25–12.8) | 84.4 (80.3–87.8) |
| IIB (n=520) | 2.34 (0.33–16.8) | 80.0 (76.0–83.5) |
| IIC (n=232) | 2.76 (0.38–19.9) | 76.7 (70.5–81.7) |
| IIIA (n=56) | 0.24 (0.02–3.81) | 97.7 (84.6–99.7) |
| IIIB (n=1,460) | 3.29 (0.46–23.4) | 78.0 (75.3–80.5) |
| IIIC (n=513) | 7.36 (1.03–52.5) | 56.3 (51.0–61.3) |
| TLNR classification | ||
| I (n=21) | 1.00 (reference) | 90.0 (47.3–98.5) |
| IIA (n=731) | 1.76 (0.25–12.6) | 84.8 (81.4–87.7) |
| IIB (n=1,413) | 2.54 (0.36–18.1) | 79.8 (77.1–82.1) |
| IIC (n=737) | 3.40 (0.48–24.3) | 73.2 (69.4–76.6) |
| IIIA (n=328) | 6.35 (0.89–45.4) | 58.2 (51.7–64.1) |
| IIIB (n=84) | 10.4 (1.44–75.6) | 47.0 (34.7–58.4) |
| IIIC (n=13) | 16.0 (2.05–125) | 36.9 (12.5–62.0) |
| Validation cohort (disease-free survival) (N=3,327) | ||
| AJCC 8th pN stage | ||
| pN0 (n=1,298) | 1.00 (reference) | 77.9 (75.2–80.2) |
| pN1a (n=723) | 1.47 (1.22–1.77) | 73.8 (69.9–77.3) |
| pN1b/1c (n=709) | 1.91 (1.60–2.28) | 66.9 (62.7–70.8) |
| pN2a (n=345) | 2.30 (1.86–2.85) | 65.5 (59.3–70.9) |
| pN2b (n=252) | 3.83 (3.11–4.72) | 45.9 (38.4–53.1) |
| LNR stage | ||
| LNR1 (n=1,513) | 1.00 (reference) | 77.7 (75.3–80.0) |
| LNR2 (n=1,308) | 1.63 (1.40–1.89) | 70.7 (67.7–73.4) |
| LNR3 (n=285) | 2.48 (2.00–3.07) | 57.9 (50.7–64.5) |
| LNR4 (n=93) | 3.29 (2.41–4.48) | 48.3 (35.8–59.8) |
| LNR5 (n=128) | 4.93 (3.87–6.28) | 38.2 (29.0–47.4) |
| AJCC 8th TNM classification | ||
| I (n=26) | 1.00 (reference) | 90.9 (50.8–98.7) |
| IIA (n=520) | 2.60 (0.36–18.7) | 81.3 (77.0–84.8) |
| IIB (n=520) | 3.18 (0.45–22.8) | 77.0 (72.8–80.6) |
| IIC (n=232) | 4.03 (0.56–29.1) | 73.1 (66.8–78.5) |
| IIIA (n=56) | 1.14 (0.13–10.2) | 90.1 (75.3–96.2) |
| IIIB (n=1,460) | 5.08 (0.71–36.2) | 71.9 (69.1–74.5) |
| IIIC (n=513) | 10.5 (1.48–75.1) | 49.7 (44.6–54.6) |
| TLNR classification | ||
| I (n=21) | 1.00 (reference) | 90.0 (47.3–98.5) |
| IIA (n=731) | 2.46 (0.34–17.6) | 81.5 (78.0–84.6) |
| IIB (n=1,413) | 3.71 (0.52–26.4) | 74.6 (71.9–77.1) |
| IIC (n=737) | 4.94 (0.69–35.2) | 67.6 (63.7–71.2) |
| IIIA (n=328) | 8.84 (1.24–63.1) | 51.3 (45.0–57.2) |
| IIIB (n=84) | 13.8 (1.91–99.8) | 39.8 (28.3–51.0) |
| IIIC (n=13) | 18.1 (2.32–141) | 36.9 (12.5–62.0) |
AJCC, American Joint Committee on Cancer; TLNR, T stage-lymph node ratio classification; TNM, tumor/node/metastasis; 5-Y OS, 5-year overall survival; DFS, disease-free survival; HR, hazard ratio; No., number; LNR, lymph node ratio.