Rebuttal from Dr. Obiols and Dr. Call

First of all, we would like to congratulate Dr. Decaluwé and Dr. Dooms for their rigorous revision on this topic. As they have commented in their manuscript, following the recommendations of the European Society of Thoracic Surgeons (ESTS) guidelines for preoperative mediastinal nodal staging, high negative predictive values (91–95%) and low rates of unsuspected pathologic (p) N2 disease (5.1–5.5%) are achieved (1,2). The majority of patients with unsuspected pN2 have single station involvement and better survival compared with the global cohort of pN2 (2).