Role of mediastinal lymph node dissection in non-small cell lung cancer

The role of systematic mediastinal lymph node dissection in the staging and treatment of non-small cell lung cancer (NSCLC) is the subject of ongoing debate. Surgical practice varies from simple visual inspection of the unopened mediastinum to radical, systematic lymphadenectomy of all accessible lymph node levels. As the evaluation of mediastinal lymph nodes is a precondition for accurate intraoperative staging of NSCLC we advocate for complete interlobar, hilar and mediastinal lymphadenectomy as compartment dissections in patients with NSCLC. The therapeutic effect of extensive mediastinal lymphadenectomy, however, remains controversial. In this review we discuss the role of mediastinal lymph node dissection in the management of NSCLC.