Outcomes Linked to 3N2+1N1 Sampling by Surgery Type: A Commission on Cancer Lung Cancer Quality Metric.
[BACKGROUND] In 2021, the Commission on Cancer implemented Standard 5.8 requiring lymph node sampling from ≥3 mediastinal and ≥1 hilar stations (3N2+1N1) during curative-intent lung cancer resections.
- 95% CI 0.39-0.98
APA
Baskin AS, Tupper HI, et al. (2026). Outcomes Linked to 3N2+1N1 Sampling by Surgery Type: A Commission on Cancer Lung Cancer Quality Metric.. Annals of thoracic surgery short reports, 4(1), 207-212. https://doi.org/10.1016/j.atssr.2025.09.012
MLA
Baskin AS, et al.. "Outcomes Linked to 3N2+1N1 Sampling by Surgery Type: A Commission on Cancer Lung Cancer Quality Metric.." Annals of thoracic surgery short reports, vol. 4, no. 1, 2026, pp. 207-212.
PMID
42027504
Abstract
[BACKGROUND] In 2021, the Commission on Cancer implemented Standard 5.8 requiring lymph node sampling from ≥3 mediastinal and ≥1 hilar stations (3N2+1N1) during curative-intent lung cancer resections. Before Standard 5.8, sampling ≥10 lymph nodes was recommended. To date, the optimal nodal sampling strategy is still unknown, particularly for sublobar resections. We assessed 3N2+1N1 sampling patterns and potential associations with recurrence and mortality by resection type.
[METHODS] In this multicenter retrospective study, we evaluated early-stage non-small cell lung cancer (NSCLC) patients who underwent lobectomy or sublobar resection (2009-2019). We calculated the proportion with 3N2+1N1 sampled. Using multivariable Cox regression, we assessed associations of 3N2+1N1 sampling with 1-year recurrence and 5-year overall mortality, stratified by lobectomy vs sublobar resection.
[RESULTS] Among 2096 lobectomy patients, 43% had 3N2+1N1 sampling. In contrast, among 386 sublobar resection patients, 23% had 3N2+1N1. We found 3N2+1N1 sampling was not significantly associated with 1-year recurrence or 5-year mortality after lobectomy, but was associated with reduced 1-year recurrence (adjusted hazard ratio, 0.62; 95% CI, 0.39-0.98) after sublobar resection.
[CONCLUSIONS] A minority of lobectomy and sublobar resection patients had 3N2+1N1 sampling. Although 3N2+1N1 sampling was not associated with improvements across all outcomes, our findings suggest that Standard 5.8 may be a meaningful step toward improved quality of lymph node evaluations in some patients.
[METHODS] In this multicenter retrospective study, we evaluated early-stage non-small cell lung cancer (NSCLC) patients who underwent lobectomy or sublobar resection (2009-2019). We calculated the proportion with 3N2+1N1 sampled. Using multivariable Cox regression, we assessed associations of 3N2+1N1 sampling with 1-year recurrence and 5-year overall mortality, stratified by lobectomy vs sublobar resection.
[RESULTS] Among 2096 lobectomy patients, 43% had 3N2+1N1 sampling. In contrast, among 386 sublobar resection patients, 23% had 3N2+1N1. We found 3N2+1N1 sampling was not significantly associated with 1-year recurrence or 5-year mortality after lobectomy, but was associated with reduced 1-year recurrence (adjusted hazard ratio, 0.62; 95% CI, 0.39-0.98) after sublobar resection.
[CONCLUSIONS] A minority of lobectomy and sublobar resection patients had 3N2+1N1 sampling. Although 3N2+1N1 sampling was not associated with improvements across all outcomes, our findings suggest that Standard 5.8 may be a meaningful step toward improved quality of lymph node evaluations in some patients.