Fig. 2: Kaplan–Meier survival curves showing overall survival probabilities (log-rank test).

For PUCH cohort, MMLN staging system showed good discriminative ability within a pN2 stage (P = 0.008), b pN3a stage (P = 0.003), c pN3b stage (P = 0.003) of the American Joint Committee on Cancer (AJCC), 8th edition, staging system. For CIAH cohort, all d AJCC, e MMLN staging system, f log odds of positive lymph nodes (LODDS) stage, g lymph node ratio (LNR) stage, h Choi’s LN stage, i Chen’s LN stage showed good prognostic performance (all P < 0.001). However, the last two or three subgroups within each of the six staging systems showed similar survival curves, d pN2 vs. pN3a, P = 0.532; pN3a vs. pN3b, P = 0.300; e MMLN2 vs. MMLN3, P = 0.361; MMLN3 vs. MMLN4, P = 0.320; f LODDS3 vs. LODDS4, P = 0.361; LODDS4 vs. LODDS5, P = 0.539; g LNR2 vs. LNR3, P = 0.225; h Choi N2 vs. Choi N3, P = 0.299; i Chen N2 vs. Chen N3, P = 0.649.