2024 World Conference on Lung Cancer (WCLC) - Posters-P1.08C.05 The Clinicopathological and Prognostic Significance of Skip-N2 Metastases: A Retrospective Multicenter Study

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The study titled "The Clinicopathological and Prognostic Significance of Skip-N2 Metastases: A Retrospective Multicenter Study" aimed to assess the significance of skip-N2 metastases in patients with primary lung cancer. Skip-N2 refers to mediastinal lymph node involvement (pN2) without preceding involvement of hilar and intrapulmonary lymph nodes (pN1). Prior research suggested that patients with skip-N2 metastases have a better prognosis compared to those with non-skip-N2 metastases, but associated clinicopathological factors have been controversial.<br /><br />The study was a retrospective multicenter analysis involving 757 patients from 22 institutions who underwent surgical resection for lung cancer between 2012 and 2021. Patients were categorized into three groups: N1 (pN1N2- group), skip-N2 (pN1-N2), and non-skip-N2 (pN1N2) groups. Skip-N2 disease was relatively frequent and associated with a favorable outcome when treated with curative surgical resection.<br /><br />Key findings from the study included:<br /><br />1. **Survival Rates:** The 5-year overall survival (OS) rates were 65% for skip-N2, 63% for N1, and 54% for non-skip-N2 patients. The 5-year relapse-free survival (RFS) was 40% for both skip-N2 and N1, and 24% for non-skip-N2, with notable statistical significance.<br /><br />2. **Clinicopathological Factors:** Tumor location, pleural involvement, and other histopathological variables were analyzed, revealing several statistically significant associations with skip-N2 status, including tumor location (right vs. left lung), pleural contact, and lymphatic invasion.<br /><br />3. **Recommendation:** The study advocates for standard hilar and mediastinal lymph node dissection during surgery, especially in non-small cell lung cancer (NSCLC) patients with pleural attachment on the right side.<br /><br />The study concluded that patients with skip-N2 metastases benefit from surgical treatment and exhibit a favorable prognosis, emphasizing the necessity for specific surgical approaches based on identified clinicopathological features. The researchers reported no conflicts of interest.

Asset Subtitle

Ken Suzawa

Meta Tag

Speaker Ken Suzawa

Topic Local-Regional NSCLC

Keywords

skip-N2 metastases

lung cancer

clinicopathological significance

prognosis

retrospective study

surgical resection

survival rates

lymph node dissection

NSCLC

pleural involvement