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Analysis of institutional authors

Albero-Gonzalez, RaquelAuthor

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January 19, 2026
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Nodal size ranking as a predictor of mediastinal involvement in clinical early-stage non-small cell lung cancer

Publicated to: Medicine. 98 (50): e18208- - 2019-12-01 98(50), DOI: 10.1097/MD.0000000000018208

Authors:

Caupena, Cristina; Costa, Roser; Perez-Ochoa, Francisco; Call, Sergi; Jaen, Angels; Rami-Porta, Ramon; Obiols, Carme; Esteban, Lluis; Albero-Gonzalez, Raquel; Antonio Luizaga, Luis; Serra, Mireia; Belda, Josep; Tarroch, Xavier; Sanz-Santos, Jose
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Affiliations

Hosp Univ Mutua Terrassa, Dept Pathol, Terrassa, Spain - Author
Hosp Univ Mutua Terrassa, Dept Pulmonol, Pl Dr Robert 5, Barcelona 08221, Spain - Author
Hosp Univ Mutua Terrassa, Dept Thorac Surg, Terrassa, Spain - Author
Mutua Terrassa Fdn, Res Unit, Terrassa, Spain - Author
Network Ctr Biomed Res Resp Dis CIBERES, Lung Canc Grp, Terrassa, Spain - Author
Univ Barcelona, Fac Med, Dept Med, Barcelona, Spain - Author
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Abstract

In non-small cell lung cancer (NSCLC) patients, the recommended minimum requirement for an endoscopy-based mediastinal staging procedure is sampling the largest lymph node (LN) in right and left inferior paratracheal, and subcarinal stations. We aimed to analyze the percentage of cases where the largest LN in each mediastinal station was malignant in a cohort of NSCLC patients with mediastinal metastases diagnosed in the lymphadenectomy specimen. Furthermore, we investigated the sensitivity of a preoperative staging procedure in a hypothetical scenario where only the largest LN of each station would have been sampled. Prospective data of patients with mediastinal nodal metastases diagnosed in the lymphadenectomy specimens were retrospectively analyzed. The long-axis diameter of the maximal cut surface of all LNs was measured on hematoxylin and eosin-stained sections. Seven hundred seventy five patients underwent operation and 49 (6%) with mediastinal nodal disease were included. A total of 713 LNs were resected and 119 were involved. Sixty seven nodal stations revealed malignant LNs: in these, the largest LN was malignant in 39 (58%). In a "per patient" analysis, a preoperative staging procedure that sampled only the largest LN would have attained a sensitivity of 0.67; and if the largest and the second largest were sampled, sensitivity would be 0.87. In patients with NSCLC, nodal size ranking is not reliable enough to predict malignancy. In clinical practice, regardless of the preoperative staging method, systematic thorough sampling of all visible LNs is to be recommended over selective random samplings.
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Keywords

mediastinummetastasesnodal sizenon-small cell lung cancernumberresectionstagingsurgeryCarcinoma, non-small-cell lungEarly-stageFemaleFollow-up studiesGood health and well-beingHumansLung neoplasmsLymph node excisionLymph nodesLymph-nodesLymphatic metastasisMaleMediastinoscopyMediastinumMetastasesMiddle agedNeoplasm stagingNodal sizeNon-small cell lung cancerNumberPrognosisResectionRetrospective studiesStagingSurgeryThoracic surgery, video-assistedTime factors

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal MEDICINE due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2019, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Medicine (Miscellaneous). Notably, the journal is positioned en el Cuartil Q3 for the agency WoS (JCR) in the category Medicine, General & Internal.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-04:

  • WoS: 5
  • Scopus: 3
  • Europe PMC: 3
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-04:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 9.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 9 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 1.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Continuing with the social impact of the work, it is important to emphasize that, due to its content, it can be assigned to the area of interest of ODS 3 - Good Health And Well-being, with a probability of 83% according to the mBERT algorithm developed by Aurora University.
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Project objectives

El estudio persigue los siguientes objetivos: analizar el porcentaje de casos en que el ganglio linfático (LN) más grande en cada estación mediastínica es maligno en pacientes con cáncer de pulmón no microcítico (NSCLC) con metástasis mediastínicas; evaluar la sensibilidad de un procedimiento de estadificación preoperatoria hipotético que muestrea únicamente el LN más grande de cada estación; determinar la mejora en sensibilidad al incluir el segundo LN más grande; caracterizar la fiabilidad del tamaño nodal como predictor de malignidad; y recomendar prácticas clínicas basadas en los hallazgos para el muestreo sistemático de ganglios linfáticos visibles en pacientes con NSCLC.
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Most relevant results

Este estudio evaluó la capacidad predictiva del tamaño nodal para identificar afectación mediastínica en pacientes con cáncer de pulmón no microcítico en estadio temprano. Se analizaron 713 ganglios linfáticos resecados en 49 pacientes con metástasis mediastínicas, encontrándose 119 ganglios malignos. En 67 estaciones nodales con ganglios malignos, el ganglio de mayor tamaño fue maligno en el 58% de los casos. El muestreo preoperatorio del ganglio más grande alcanzó una sensibilidad del 67%, que aumentó al 87% al incluir el segundo ganglio más grande. Estos resultados indican que la clasificación por tamaño nodal no es suficientemente fiable para predecir malignidad, recomendándose un muestreo sistemático y exhaustivo de todos los ganglios visibles.
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