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

Ann Thorac Surg. 2007 Sep;84(3):1059-65. doi: 10.1016/j.athoracsur.2007.04.032.


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.

Publication types

  • Review

MeSH terms

  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Lymph Node Excision
  • Lymph Nodes / pathology*
  • Mediastinoscopy
  • Mediastinum / pathology*
  • Neoplasm Staging
  • Thoracic Surgery, Video-Assisted