Investigating the characteristics of skip N2 metastasis in NSCLC

Objective To analysis the clinicopathological features of skip N2 metastasis in NSCLC in our clinical center, therefore guide for clinical decision making for NSCLC patients. Methods A total of 120 NSCLC patients with N2 metastasis treated by surgery were enrolled from January 2017 to May 2018, of which 55 were males and 65 were females. The mean age of them were (58.36±11.34) years old. 36 patients had skip N2 metastasis, accounting for 30% of patients with N2 metastasis. 48 patients had a history of smoking or a definitive history of second-hand smoke exposure, compared with other 72 patients. Collected pre- and post-operation clinical data of those patients, and carried out relevant statistical analysis. Results Among the NSCLC with skip N2 metastasis, it occulted more frequently in right lower lobe and peripheral lung cancer. The main pathological type was adenocarcinoma with acinar subtype. The most cases of skip N2 metastasis were characterized by single N2 station metastasis. Age of patients showed a significant difference between the two groups(P=0.049). Gender, smoking history, T staging of lung cancer, pathological type and involvement of pulmonary membrane showed no statistic difference between the two groups(P>0.05). Conclusion Patient with skip N2 metastasis seemed to be elder, and the lesions of those patients were more likely to be lung adenocarcinoma in the right lower lobe and peripheral lung cancer, often involved single N2 station. The lung cancer in right upper lobe often skipped to level R2+ R4, which in right middle lobe often skipped to levels R2+ R4 and 7, in right and left lower lobes skipped to level 7, in the left upper lobe often skipped to level 5. Key words: Non-small cell lung cancer; Skip metastasis; Clinicopathological features