非小细胞肺癌和淋巴结阳性病患者是一个异质性群体，其疾病模式多种多样。本研究旨在评估与N1疾病或非跳跃性N2疾病相比，患有跳跃性N2疾病的患者的长期预后。对2012年至2019年间行解剖性肺叶切除术治疗原发性肺癌且术后病理确认存在淋巴结阳性的445名患者进行回顾性分析。采用对数秩和检验方法评估淋巴结状态对预计中位总生存期的差异。进行多因素Cox回归分析以确定跳跃性N2疾病是否独立与总体生存率相关联。平均患者年龄为67.0岁（标准差±9.2岁），其中男性占48.1％（n=214）。总共，20.7％（n=92）的患者患有N1疾病，32.1％（n=143）的患者患有跳跃性N2疾病，47.2％（n=210）的患者患有非跳跃性N2疾病。术后升级发生在33.0％（n=147）的患者中。中位随访时间为35个月（四分位距14-68个月）。与非跳跃性N2疾病患者相比，跳跃性N2疾病患者的预计中位总生存期显著更长（47个月vs 28个月，对数秩和检验P=0.029），而在多因素分析后，非跳跃性N2疾病仍然与降低的总体生存率相关（风险比1.421，95％置信区间1.060-1.907，P=0.019）。跳跃性N2疾病是N2期肺癌患者的积极预后因素，这意味着肺癌分期指南应考虑将N2疾病分为更多的亚组以提高预后准确性。版权© 2023 Elsevier B.V.保留所有权利。

Patients with non-small cell lung cancer and nodal disease are a heterogeneous group with varied patterns of disease. The aim of this study was to assess long-term outcomes of patients with skip N2 disease in comparison to those with N1 or non-skip N2 disease.A retrospective review of 445 patients undergoing anatomical lung resection for primary lung cancer between 2012 and 2019 with post-operative histological confirmation of nodal disease was undertaken. Log rank analysis was used to assess differences in estimated median overall survival according to nodal status. Multivariable Cox regression analysis was performed to determine whether skip N2 disease was independently associated with overall survival.Mean patient age was 67.0 years (standard deviation ± 9.2 years) and 48.1% (n = 214) were male. In total, 20.7% (n = 92) of patients had N1 disease, 32.1% (n = 143) had skip N2 disease and 47.2% (n = 210) had non-skip N2 disease. Post-operative upstaging took place in 33.0% (n = 147) of patients. Median follow-up time was 35 months (interquartile range 14-68 months). Skip N2 patients had significantly longer estimated median overall survival in comparison to their non-skip N2 counterparts (47 months vs 28 months, log rank analysis p = 0.029) and non-skip N2 disease remained independently associated with reduced overall survival after multivariable analysis (hazard ratio 1.421, 95% confidence interval 1.060-1.907, p = 0.019).Skip N2 disease is a positive prognostic factor for patients with N2 lung cancer, suggesting that lung cancer staging guidelines should consider separating N2 disease into additional subgroups in order to improve prognostic accuracy.Copyright © 2023 Elsevier B.V. All rights reserved.