Author of

• 11595

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  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11598

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    P2.07-003 - Sampling vs. systematic full lymphatic dissection in surgical treatment of non-small cell lung cancer (ID 340)

    09:30 - 09:30  |  Author(s): G. Koulaxouzidis
    • Abstract

    Background
    The extent of mediastinal lymph node assessment during surgery for non-small cell cancer remains controversial. Different techniques are used, ranging from simple visual inspection of the unopened mediastinum to an extended bilateral lymph node dissection. Furthermore, there are different terms to define these techniques: Sampling is the removal of one or more lymph nodes guided by preoperative finding. Systematic (full) nodal dissection is the removal of all mediastinal tissue containing the lymph nodes systematically within anatomical landmarks.

    Methods
    A Medline search was conducted to identify articles in English, addressing the role of mediastinal lymph nodes resection in the treatment of NSCLC

    Results
    Opinions favoring full lymphatic dissection include complete resection, improved nodal staging and better local control due to resection of undetected micrometastasis. Arguments against routine full lymphatic dissection are increased morbidity, increased operative time and lack of evidence of improved survival. For complete resection of non-small cell lung cancer a systematic nodal dissection is recommended for many authors, as the standard approach during surgery: it ascertains both adequate nodal staging and completeness of resection.

    Conclusion
    Whether extending the lymph node dissection influences survival or recurrence rate remains to be determined. There are valuable arguments in favor of not only an improved local control but also an improved long-term survival. However, the impact of lymph node dissection in long-term survival should be further assessed by large-scale multicenter randomized trials.