Selective lymph node dissection in early-stage non-small cell lung cancer

Abstract

Lymph node dissection is a vital part of surgical treatment in early-stage non-small cell lung cancer (NSCLC). Removal of metastatic lymph nodes while preservation of intact lymph nodes are equally important. For hospitalized early-stage patients with limited lymph node metastasis, the operation treatment should be made according to some rules such as lobe-specific lymph node drainage pattern. In order to prevent unnecessary surgical trauma in early-stage patients, a minimally invasive approach with selective lymph node excision is preferred for more clinical benefits. This review summarizes the existing findings on lobe-specific lymph node drainage pattern and we hope to provide guidance for selective lymph node dissection (SLND). Furthermore, we include information on histologic views, a tumor marker and protocols of SLND, with hope to inspire creative research and clinical trials in this field.

Development of a predictive radiomics model for lymph node metastases in pre-surgical CT-based stage IA non-small cell lung cancer

“…Pathologyrelated biopsy and thoracoscopy evaluate the LN staging better than radiological images, however, these would be invasive procedures for the patients [9,10]. Surgical LN dissection in early stage NSCLC patients with non-LNM was usually considered as an overtreatment, which could cause trauma and other negative impacts during the recovery of the patient [11]. Hence, it was considered imperative to find new and valuable imaging methods to predict LNM in the NSCLC patients.…”

Tumor necrosis factor superfamily 15 promotes lymphatic metastasis via upregulation of vascular endothelial growth factor‐C in a mouse model of lung cancer

“…Metastasis is the major cause of death in cancer patients, including lung cancer, and the spread of tumor cells to lymph nodes has been the main negative prognostic factor for lung cancer . Lymphatic metastasis is considered a major route for cancer cell dissemination, and the spreading of tumor cells to lymph nodes is a common lymphatic‐mediated metastasis pattern for carcinomas, draining either through preexisting lymphatic vessels or via the newly formed lymphatic capillaries . However, the pathobiology for lymphatic metastasis has remained unclear.…”

Combined Off-Pump Coronary Artery Bypass Grafting and Lung Resection in Patients with Lung Cancer Accompanied by Coronary Artery Disease

“…With sternotomy, hilar, interlobar, lobar, segmental and inferior pulmonary lymph nodes at both mediastinal, and subcarinal lymph nodes on the left side may be sampled [ 8 ] . Although systematic LND is recommended [ 20 ] , selective LND is also an acceptable option in LC surgery for adequate tumor cleaning and staging for stage 1 and 2 tumors [ 9 ] . The reported possible advantage of selective LND is reducing the hospital stay, but its reliability and applicability are still unclear.…”

“…Selective lymph node dissection (LND) was performed in all patients [ 9 ] . Stations #2R and #4R were dissected for right upper lobe (RUL) tumor and stations #4, #5 and #6 were dissected for left upper lobe (LUL) tumors.…”