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Is there a role for the use of radical lymph node dissection in the surgical management of resectable non-small cell lung cancer?

Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK

jamesbbarnard{at}doctors.org.uk

^* Corresponding author. Tel.: +44-780-154-8122; fax: +41-161-276-8538
joeldunning{at}doctors.org.uk

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether there is any survival benefit to the employment of the technique of radical lymph node dissection in the management of operable non-small cell lung cancer (NSCLC). Altogether 305 papers were found using the reported search, of which eight presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that extensive lymph node sampling is of benefit in accurately staging NSCLC, however, the design of studies in the literature has failed to account for the staging effect of extensive lymph node dissection on upstaging cancer patients when trying to determine a survival advantage.

Key Words: Evidence-based medicine; Thoracic surgery; Lymph node excision; Lung neoplasms

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