Resected non-small cell lung cancer: need for adjuvant lymph node treatment? From hope to reality

Even if postoperative thoracic radiotherapy has been widely used as adjuvant treatment, the oncological community has poorly evaluated this treatment after complete surgical resection in lung cancer. The number of patients included in randomised trials has been less than 3000. The analysis of these trials showed rather a deleterious effect in terms of overall survival, suggesting a lethal late treatment-related toxicity in early stage I or II disease. In N2 disease, these effects have not been demonstrated but information is lacking to consider this treatment on an evidence-based medicine policy. We discuss here the available worldwide information on this subject. There is an urgent need for new trials in this topic.