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Surgical assessment and intraoperative management of mediastinal lymph nodes in non-small cell lung cancer.

Whitson BA, Groth SS, Maddaus MA

University of Minnesota Department of Surgery, Section of Thoracic and Foregut Surgery, Minneapolis, Minnesota 55455, USA.

Mediastinal lymph node status has important prognostic and therapeutic implications for nonsmall cell lung cancer patients. Consequently, an accurate pathologic assessment of mediastinal lymph nodes for metastasis is essential. Despite the significance of nodal assessment, practice patterns among surgeons vary widely. Therefore we reviewed the literature to provide evidence-based recommendations regarding the ideal means and extent of preoperative and intraoperative pathologic mediastinal lymph node staging in non-small cell lung cancer patients. We found that the most sensitive and accurate intraoperative method is a complete mediastinal lymph node dissection. Pathologic evaluation of at least 10 mediastinal lymph node from at least three stations should be performed at the time of surgery.

Published 27 August 2007 in Ann Thorac Surg, 84(3): 1059-65.
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