General Thoracic and Cardiovascular Surgery

, Volume 60, Issue 11, pp 724–734

Mediastinal lymph nodes: Ignore? Sample? Dissect? The role of mediastinal node dissection in the surgical management of primary lung cancer

Guest Review Article


The role of mediastinal lymph node dissection (MLND) during the resection of non-small-cell lung cancer is still unclear although most surgeons agree that a minimum of hilar and mediastinal nodes must be examined for appropriate pathological staging. Current surgical practices vary from visual inspection of the mediastinum with biopsy of only abnormal looking nodes to systematic mediastinal node sampling which is to the biopsy of lymph nodes from multiple levels whether they appear abnormal or not to MLND which involves the systematic removal of all lymph node bearing tissue from multiple sites unilaterally or bilaterally within the mediastinum. This review article looks at the evidence and arguments in favour of lymphadenectomy, including improved pathological staging, better locoregional control, and ultimately longer disease-free survival and those against which are longer operating time, increased operative morbidity, and lack of evidence for survival benefit.


Lung cancer Surgery for lung cancer Mediastinal lymphadenectomy 

Supplementary material

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Supplementary material 1 (JPEG 1702 kb)


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© The Japanese Association for Thoracic Surgery 2012

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryInstitut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ)QuebecCanada

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