Clinical and Pathological Characteristics and Survival Analysis of NSCLC Patients with Skip Metastasis in Stage pN2/III

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Pathology/Molecular Biology
Presenter lemeng Zhang
Citation Annals of Oncology (2018) 29 (suppl_9): ix143-ix149. 10.1093/annonc/mdy446
Authors L. Zhang
  • Thoracic Department, Hunan provincial cancer hospital, 410006 - Changsha/CN



NSCLC (non-small cell lung cancer) with mediastinal lymph node metastasis is a kind of highly heterogeneous disease. There are significant differences in the treatment strategy and prognosis in different sub-types of N2 NSCLC patients. Therefore, it is very necessary to further divide the N2.


Patients with NSCLC in the Department of thoracic surgery in Hunan cancer hospital were treated with surgical treatment and were staged III after operation. The clinical and pathological data were analyzed retrospectively, and the patients were followed up. Patients were grouped according to different N2 lymph node metastasis status. The difference between different groups was analyzed, and the independent influencing factors were evaluated.


After screening, 162 patients with III/pN2 non-small cell lung cancer were enrolled, 27 cases of N2a1 (single station N2 skip metastasis), 49 cases of N2a2, 17 cases of N2b1 and 69 cases of N2b2, represent 16.7%, 30.2%, 10.5%, 42.6% respectively. There were significant differences in the mode of operation, the site of the mass, the site of the mass, the number of the mediastinal lymph node dissection stations, the number of the mediastinal lymph node metastasis stations, the number of mediastinal lymph node metastasis, the lymph node metastasis and the total dissection rate of lymph nodes in the two groups, including the tumor site, the largest diameter of tumor(P = 0.012) were independent risk factors for skip metastasis.The prognosis analysis showed that the median DFS of patients with N2a1, N2a2, N2b1 and N2b2 was 54.7 months, 27.4 months, 21.0 months and 13.4 months respectively. The median OS was not reached, 49.2 months, 38.6 months and 36.5 months respectively. The 3 years DFS rate was 66.7%, 43.1%, 11.8% and 18.8%, respectively. The 5 years OS rate was 57.3%, 44.9%, 26.5% and 13.8%, respectively.


The location and size of tumor are independent factors of skip metastasis. According to whether single metastasis station and whether skip metastasis, the N2 phase is divided into 3 subtypes, and there was significant difference in survival among different subtypes.

Editorial acknowledgement


Clinical trial identification


Legal entity responsible for the study

Hunan Cancer Hosptial.


Has not received any funding.


The author has declared no conflicts of interest.