[Lymph node documentation and lymphadenectomy in bronchial carcinomas. Results of a survey in Germany]

A number of different mapping systems have been published for the lymph-node staging in lung cancer. The use of a reproducible map is an essential prerequisite for correct determination of the TNM status and comparing the surgical results. In order to evaluate the current status of lymph-node mapping and lymph-node dissection in Germany, we performed a mail survey involving 90 hospitals performing operations for lung cancer. Responses were obtained from 61 (67.7%) hospitals. Currently, the majority of the departments (43%) use the German staging system (according to the Deutsche Gesellschaft für Thorax-, Herz- und Gefässchirurgie/Pneumologie), 23% lymph-node mapping according to Naruke, and 25% an individual description of the resected lymph nodes. The number of resected lymph nodes is reported in 75% of the departments, the quotient of involved/not involved lymph nodes in 33%. Mediastinal lymph-node sampling guided by the intraoperative aspect of lymph nodes is performed in 59% of the departments. A systematic mediastinal "enbloc" resection is accomplished in 41%. The results of this survey represent the current status of lymph-node mapping and lymphadenectomy in lung cancer in Germany and might be useful for the development of a uniform staging system.