Lymph node dissection for lung cancer: significance, strategy, and technique

Since Cahan (1960) reported the first 48 cases that successfully underwent lobectomy with regional lymph node dissection, which was called "radical lobectomy", this procedure was universally accepted and has remained a standard surgery for lung cancer. In recent decades, the intrathoracic reevaluation of disease at thoracotomy for lung cancer has evolved into a detailed and sophisticated assessment of disease extent. Central to this is an evaluation of nodal involvement at the mediastinal and hilar levels. This technique, termed "systematic nodal dissection" (SND), has been accepted by the IASLC to be an important component of intrathoracic staging. In this manuscript, the significance, recent strategy, and technique of lymph node dissection for lung cancer are described.