[Systematic Nodal Dissection for Lung Cancer]

Since Cahan (1960) reported the 1st 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 International Association for the Study of Lung Cancer( IASLC) to be an important component of intrathoracic staging. SND is carried out by excising all tissue in the compartment surrounded by some anatomic structures with scissors or electrocautery. The significance of lymph node dissection can be discussed from 2 clinical aspects, accurate staging and survival benefit. In this manuscript, the significance, recent strategy, and technique of lymph node dissection for lung cancer are described.