Lymph node dissection for lung cancer: past, present, and future

Abstract

In 1978, Naruke et al. proposed an anatomical map that included numbered lymph node stations, which then became widely used for nodal dissection. In 1997, Mountain and Dresler published a new map, which is now favored by the American Thoracic Society and the European Respiratory Society. Using these maps, regional nodal dissection has been universally performed in lung cancer surgery. Clear evidence regarding the survival benefit of lymph node dissection for lung cancer is lacking. However, lobectomy with lymph node dissection continues to be a standard surgical procedure for lung cancer because lymph node dissection is an important investigative process in staging patients. Over the last decade, the extent of nodal dissection for lung cancer has changed due to the increasing number of early detected lung cancers made possible by the recent development of the CT scanner. This manuscript describes the history, present strategy, and future perspectives of lymph node dissection for lung cancer.