Skip metastases: analysis of their clinical significance and prognosis in the IIIA stage of non-small cell lung cancer

Misthos, Panagiotis; Sepsas, Evangelos; Athanassiadi, Kalliopi; Kakaris, Stamatios; Skottis, Ion

doi:10.1016/j.ejcts.2004.01.025

Cited by 64 publications

(54 citation statements)

References 21 publications

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“…[1,5] Therefore, the examination of lymph nodes is critical step. [6,7] The incidence of pathological N2 disease following surgical resection and systematic mediastinal lymph node dissection varies between 17.6 and 26.5%.…”

Section: Discussionmentioning

confidence: 99%

“…[5] In the present study, we used systematic mediastinal lymph node dissection rather than mediastinal lymph node sampling, and accordingly, ipsilateral mediastinal lymph node dissection was performed in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, there is no consensus about the presence of a predominant histological type in sN2 patients. [8,[10][11][12] Squamous-cell carcinomas are more common in the sN2 group in several studies, [5,13,14] whereas the incidence of adenocarcinomas is higher in the other studies. [3,8,10] The squamous-cell carcinomas were reported to cause sN2 more commonly in our patient group; however, we found no statistically significant difference in the sN2 rates between the squamous-cell carcinomas and adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…[5,10,[15][16][17] Riquet et al [8] showed that the five-year survival outcomes were significantly higher in patients with skip metastases. However, Tanaka et al [13] compared the five-year survival rates of sN2 patients and nsN2 patients, and found no significant difference.…”

Section: Discussionmentioning

confidence: 99%

“…[2] In some cases with unexplained mechanisms, the mediastinal lymph node metastasis occurs without the intraparenchymal and hilar lymph node involvement, which is known as a skip metastasis. [3][4][5] In this study, we aimed to examine skip metastases in patients who had resection due to NSCLC and compare the results with those without a skip metastasis.…”

mentioning

confidence: 99%

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Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Akçay¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada küçük hücreli dışı akciğer kanseri nedeni ile rezeksiyon yapılan hastalarda skip metastazları incelendi. Çalışma planı: Kliniğimizde Ocak 2005 -Aralık 2011 tarihleri arasında küçük hücreli dışı akciğer kanseri tanısı konan ve R0 akciğer rezeksiyonu örneklerinin patolojik incelemesi sonucunda aynı taraf mediastinal lenf nodu metastazı saptanan toplam 111 hasta (94 erkek, 17 kadın; ort. yaş: 58.9±10.2 yıl; dağılım 35-82 yıl) retrospektif olarak incelendi. Hastalar skip metastazlı grup (sN2) (grup 1, n=55) [N1(-), N2(+)] ve skip metastazı olmayan aynı taraf mediastinal lenf nodu metastazlı grup (nsN2) (grup 2, n=56) [N1(+), N2(+)] olmak üzere iki gruba ayrıldı. Bul gu lar: Her iki çalışma grubunda medyan sağkalım 25 ay olup, beş yıllık genel sağkalım oranı %13 idi. Beş yıllık genel sağkalım oranı grup 2'ye kıyasla grup 1'de daha yüksek olmakla birlikte (sırasıyla %7.4'e karşın %20), fark istatistiksel olarak anlamlı değildi (p=0.084). Sonuç: Çalışma sonuçlarımız istatistiksel olarak anlamlı bir fark olmasa da skip metastazı olmayan hastalara kıyasla, skip metastazlı ameliyat edilebilir hastalarda beş yıllık genel sağkalım oranının daha yüksek olduğunu göstermektedir.Anahtar sözcükler: Mediastinal lenf nodu; küçük hücreli dışı akciğer kanseri; skip metastazı. ABSTRACTBackground: This study aims to examine skip metastases in patients who had resection due to non-small cell lung cancer. Methods: A total of 111 patients (94 males, 17 females; mean age: 58.9±10.2 years; range 35 to 82 years) who were diagnosed with non-small cell lung cancer and in whom an ipsilateral mediastinal lymph node metastasis was detected based on the pathological examination of the R0 pulmonary resection samples between January 2005 and December 2011 in our clinic were retrospectively analyzed. The patients were divided into two groups: the skip metastasis group (sN2) (group 1, n=55) [N1(-), N2(+)] and non-skip ipsilateral mediastinal lymph node metastasis group (nsN2) (group 2, n=56) [N1(+), N2(+)]. Results: The median survival was 25 months and fiveyear overall survival rate was 13% for both study groups. Five-year overall survival rate was higher in group 1, compared to group 2 (20% vs. 7.4%, respectively), although the difference was not statistically significant (p=0.084). Conclusion: Our study results show that five-year overall survival rates of operable patients with skip metastases are higher than those without skip metastases, although the difference is not statistically significant.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Akçay¹

2017

Turk Gogus Kalp Dama

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Staging of Bronchogenic Carcinoma

Turner

Wang

2020

Flexible Bronchoscopy

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The problem of direct lymph drainage of the bronchopulmonary segments into the mediastinal and hilar lymph nodes

Topol

Masłoń

2009

Clinical Anatomy

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The phenomenon of skip metastases depends on the occurrence of direct metastases of non-small cell lung cancer into mediastinal lymph nodes without the involvement of hilar lymph nodes. The medical literature suggests that this prevalence ranges between 13 and 37.8% of cases. The goal of our study was to evaluate the prevalence of subpleural superficial lymphatic vessels carrying the lymph from the bronchopulmonary segments directly to the mediastinal nodes thus skipping the hilar nodes and determine whether there is a tendency towards differentiation in lymph drainage between males and females. During autopsy, 27 left and 27 right lungs were removed from 19 male and eight female cadavers. The lymphatic vessels were visualized at the mediastinal and interlobar surface of the lung by visual inspection. These vessels were then cannulated and injected with drawing ink. The first lymph node to become ink-colored via injection was dissected and histologically examined. The lymph flowed into hilar lymph nodes in 79.5% of the cases and into the mediastinal nodes in 20.5% of all the 83 vessels injected; of these 13.2% were from the right lung and in 7.2% from the left lung. The upper right lobe (5/14 vessels) and its anterior segment (3/14 vessels) were the most common source of the direct lymph drainage to the mediastinum. Vessels of 15.4% in female cadavers (4/26) and 22.8% vessels in male cadavers (13/57) traveled directly to mediastinal nodes skipping the hilar nodes. This difference was not statistically significant.

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Skip metastases: analysis of their clinical significance and prognosis in the IIIA stage of non-small cell lung cancer

Cited by 64 publications

References 21 publications

Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Staging of Bronchogenic Carcinoma

The problem of direct lymph drainage of the bronchopulmonary segments into the mediastinal and hilar lymph nodes

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