Intrapulmonary lymph node retrieval: unclear benefit for aggressive pathologic dissection

Lymph node (LN) status is a highly significant component of staging non-small cell lung cancer (NSCLC). Staging of NSCLC provides prognostic data related to risk of recurrence as well as overall survival (1). Lymph node metastasis alters treatment decisions, including surgical resectability and appropriateness of adjuvant interventions. Current pathologic LN sampling techniques often evaluate a low number of LNs (2-4). Goals of current staging techniques include sampling at minimum three N1 (hilar) nodes examined in settings of resectable disease (5). Patients harboring N1 metastatic disease are a heterogeneous group with a calculated 5 year overall survival (OS) of 38% (1) with widely variable range from 27-67% (1,6,7).