Supraclavicular Lymph Node Metastases in Advanced Lung Cancer: Prevalence and Analysis of Demographic, Clinical and Molecular Characteristics

Rocco Trisolini ¹, Valeria Cetoretta ², Giovanni Sotgiu ³

¹Interventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Hearth, Rome, Italy.
²Interventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Hearth, Rome, Italy; Department of Oncology, University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Turin, Italy.
³Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.
⁴Pathology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
⁵Interventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Hearth, Rome, Italy; Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
⁶Department of Oncology, University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Turin, Italy.
⁷Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
⁸Medical Oncology Division, IRCCS Regina Elena National Cancer Institute, Rome, Italy Medical.
⁹Oncology Division, Gemelli Isola Hospital, Catholic University of the Sacred Hearth, Rome, Italy.

⁰Interventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Hearth, Rome, Italy.

Clinical Lung Cancer +

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March 4, 2025

View abstract on PubMed

Summary

Supraclavicular lymph node metastases (SNM) are common in advanced lung cancer, especially small cell lung cancer and adenocarcinoma. Ultrasound-guided biopsy of these nodes offers a simple method for diagnosis and molecular profiling.

Area Of Science

Oncology
Pulmonology
Diagnostic Imaging

Background

The prevalence and characteristics of supraclavicular lymph node metastases (SNM) in advanced lung cancer remain under-evaluated.
Limited data exists comparing patient demographics, clinical features, and molecular profiles with and without SNM.

Purpose Of The Study

To systematically evaluate the prevalence of SNM in advanced lung cancer.
To compare demographic, clinical, and molecular characteristics between patients with and without SNM.
To assess the utility of ultrasound-guided biopsy for SNM in diagnosis and molecular profiling.

Main Methods

Prospective cohort study involving 348 patients with suspected advanced lung cancer.
Evaluation of SNM using CT, PET, and neck ultrasonography.
Ultrasound-guided biopsy for confirmation of metastatic involvement and molecular profiling.

Main Results

SNM was present in 27% (94/348) of patients.
SNM was more frequent in small cell lung cancer (50%) and adenocarcinoma (24.6%) than squamous cell carcinoma (11.4%).
Patients with SNM had higher rates of small-cell lung cancer, advanced stage disease (N2/3), liver metastases, and metastases to uncommon sites.

Conclusions

SNM is a frequent finding in advanced small cell lung cancer and adenocarcinoma.
Ultrasound-guided biopsy of SNM is an effective, simple, and cost-efficient method for tissue acquisition for diagnosis and comprehensive molecular profiling.

Keywords:

Adenocarcinoma Next generation sequencing Programmed cell death ligand-1 Small-cell lung cancer Ultrasound guided-biopsy