Abstract
Factors on nodal up-staging in clinical N0 adenocarcinoma patients who had minimally invasive anatomic lung resections
Highlights
Lung cancer is one of the leading causes of death worldwide
We were unable to demonstrate a relationship between T stage and N status
Factors contributing to unexpected N positivity were tumor characteristics that could not be identified in the preoperative period
Summary
Anatomic lung resections with systematic lymph node dissection have become the recommended treatment for early stage nonsmall lung cancer (NSCLC)[1]. Many investigators and clinicians recommend systematic nodal dissection to all lung cancer patients except those with clinical stage I disease[2]. Debate continues over whether systematic lymph node dissection is necessary for all patients with T1 or T2 tumors without signs of metastatic disease on preoperative clinical staging studies, such as CT-PET/CT, endobronchial ultrasound (EBUS), and endoscopic ultrasonography (EUS)[5,6]. Watanabe et al.[7] advocated that mediastinal nodal dissection would be unnecessary in patients with peripheral small lung cancers (≤ 1 cm for adenocarcinomas and 2 cm for tumors other than adenocarcinoma). We speculated that upstaging may be related to surgical technique and may change in the hands of the same surgeons with different surgical techniques
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