[Lymphadenectomy in bronchial carcinoma: facts and fiction]

Removal of mediastinal lymph nodes is essential for the surgical staging of lung cancer; it is therefore integral part of a curative surgical treatment. The accuracy of mediastinal staging - "biopsy" sampling or complete removal of mediastinal lymph nodes - is of significance since the N-status affects treatment and survival. Anatomical and technical considerations lead to the conclusion: Because of the anatomy of the lymph system a complete removal of all draining lymph vessels is not possible. However, accurate mediastinal staging is clearly recommended over "biopsy"-sampling. Future studies should focus on an improved histologic evaluation and should take other "new" factors affecting prognosis into consideration.