{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T22:08:25Z","timestamp":1767910105289,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Introduction: Nodal involvement is one of the most important prognostic factors in NSCLC. Skip-N2 metastasis (N0N2), which is N2 metastasis in the absence of N1 metastasis, occurs in approximately 20\u201330% of patients. According to the International Association for the Study of Lung Cancer, N1 and N0N2 patients may have comparable long-term survival, considering their similar tumor stages. However, this conclusion remains controversial. Therefore, we carried out this multicenter study to examine the long-term survival and disease-free interval (DFI) of N0N2- and N1 patients. Methods: One-, three-, and five-year survival rates were measured. Kaplan\u2013Meier curves and a Cox proportional hazards model assessed survival and were used to identify prognostic factors for overall survival. Results: Between January 2010 and December 2020, 273 N0N2 and N1 patients were included in our analysis. Of those patients, 77 showed N0N2 and 196 N1. Baseline characteristics did not differ significantly between groups. Between N0N2 and N1 patients, there were no significant differences in one- (p = 0.67), three- (p = 0.20), and five-year (p = 0.27) survival. Furthermore, DFI did not differ between groups (p = 0.45). Conclusions: Our findings indicate that N0N2 patients have a prognosis comparable to that of patients with N1 disease. These results indicate that patients with N0N2 have a similar prognosis to N1 patients. N2-NSCLC is heterogeneous and would benefit from a more precise subdivision and differential treatment in the upcoming UICC 9 classification. The following question remains: are we overtreating N0N2 patients or undertreating N1 patients?<\/jats:p>","DOI":"10.3390\/jpm15030113","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T07:02:16Z","timestamp":1741935736000},"page":"113","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Non-Small Cell Lung Cancer Patients with Skip-N2 Metastases Have Similar Survival to N1 Patients\u2014A Multicenter Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7118-8432","authenticated-orcid":false,"given":"Georg","family":"Schlachtenberger","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Hildegardis Hospital Cologne, Bachemer Strasse 29\u201333, 50931 Cologne, Germany"},{"name":"Department of General, Visceral and Thoracic Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7897-7116","authenticated-orcid":false,"given":"Simon","family":"Schallenberg","sequence":"additional","affiliation":[{"name":"Department of Pathology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0878-0406","authenticated-orcid":false,"given":"Fabian","family":"Doerr","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Medicine Essen\u2014Ruhrlandklinik, University Duisburg-Essen, 47057 Duisburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hruy","family":"Menghesha","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Helios Clinic Bonn\/Rhein-Sieg Bonn, 53123 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Gaisendrees","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Amorin","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Thoracic Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9738-5394","authenticated-orcid":false,"given":"Alberto","family":"Lopez-Pastorini","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Thoracic Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8806-4786","authenticated-orcid":false,"given":"Reinhard","family":"B\u00fcettner","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3537-6011","authenticated-orcid":false,"given":"Alexander","family":"Quaas","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Horst","sequence":"additional","affiliation":[{"name":"Department of Pathology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick","family":"Klauschen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7452-7129","authenticated-orcid":false,"given":"Nikolaj","family":"Frost","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Respiratory Medicine, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens C.","family":"Rueckert","sequence":"additional","affiliation":[{"name":"Department of Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Neudecker","sequence":"additional","affiliation":[{"name":"Department of Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khosro","family":"Hekmat","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Thoracic Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias B.","family":"Heldwein","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Thoracic Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 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