Methastatic N2 in T1 Non-small cell lug cancer: Should we go back to invasive staging?

Aim: T1 patients who were operated due to non-small cell lung cancer (NSCLC)were evaluated retrospectively. The objective of thisstudy was to evaluate metastatic lymph node status in T1 tumors and to discuss staging approaches in these tumors.Material and Methods: A total of 217 patients who met specified criteria between May 2012 and May 2019 were included in thestudy. Patients operated due to NSCLC who have a tumor size < 3 cm were evaluated in terms of age, gender, preoperative diagnosticmethods, thorax CT and PET-CT examinations, size, anatomic localization and histopathologic type of tumors, excised mediastinallymph nodes and pathology results.Results: Of total 292 lymph node stations sampled in patients with adenocarcinoma, 257 (89.73%) were reported as benign and30 (10.27) as malignant according to pathologic results. Of total 316 lymph node stations sampled in patients with squamous cellcarcinoma, 298 (94.3%) were benign and 18 (5.7%) were malignant.N2 positivity was found in 40 (18.43%) of the 217 patients.Conclusion: Mediastinoscopy should be performed for staging in the presence of a tumor size above 2 cm, histopathological type ofadenocarcinoma, high mass SUVmax values, lymph node with radiological growth and pathological involvement.

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