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Updated: Jul 16, 2026
Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
[Appropriate extent of lymph node dissection for clinical I a stage non-small cell lung cancer]
Tie-Cheng Pan1, Zhi Zheng, Jun Li
1Department of Thoracic and Cardiac Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China. tongjipantiecheng@hotmail.com
Background & Objective:
There is no agreement on the appropriate extent of lymph node dissection for lung cancer, especially for early non-small cell lung cancer (NSCLC). This study was to explore the appropriate extent of lymph node dissection for early NSCLC by investigating the metastasis regulations of hilar and mediastinal lymph nodes.
Methods:
Forty-one clinical Ia stage NSCLC patients received lobectomy and systematic mediastinal lymphadenectomy in Tongji Hospital from Jan. 2002 to Dec. 2004. The removed lymph nodes were subjected for pathologic examination. The metastasis regulations of hilar and mediastinal lymph nodes were investigated.
Results:
A total of 295 groups of lymph nodes were removed. Among them, 42 (14.2%) groups had metastasis, including 33 groups of hilar lymph nodes and 9 of mediastinal lymph nodes. Four patients had mediastinal lymph node metastasis in the 7th station, 2 in the 5th station, 2 in the 9th station, and 1 in the 4th station. The patients with tumors in the upper lobe had metastasis in the 5th or 7th station lymph nodes; the patients with tumors in the middle or lower lobe had metastasis in the 4th, 7th, or 9th station.
Conclusions:
The metastasis regulations of hilar and mediastinal lymph nodes in Ia stage NSCLC is accordant to regional lymph node drainage regulations. Selective regional lymph node dissection might be applied in these patients, that is, upper mediastinal lymph node, not lower mediastinal lymph node, should be removed when the tumor is in the upper lobe without hilar or subcarinal lymph node metastasis, while all mediastinal lymph nodes should be removed when the tumor is in the middle or lower lobe.