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Title: ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer
Authors: Lardinois, Didier ×
De Leyn, Paul
Van Schil, Paul
Porta, Ramon Rami
Waller, David
Passlick, Bernward
Zielinski, Marcin
Lerut, Antoon
Weder, Walter #
Issue Date: Oct-2006
Series Title: European Journal of Cardio-Thoracic Surgery vol:30 issue:5 pages:787-92
Abstract: The European Society of Thoracic Surgeons (ESTS) organized a workshop dealing with lymph node staging in non-small cell lung cancer. The objective of this workshop was to develop guidelines for definitions and the surgical procedures of intraoperative lymph node staging, and the pathologic evaluation of resected lymph nodes in patients with non-small cell lung cancer (NSCLC). Relevant peer-reviewed publications on the subjects, the experience of the participants, and the opinion of the ESTS members contributing on line, were used to reach a consensus. Systematic nodal dissection is recommended in all cases to ensure complete resection. Lobe-specific systematic nodal dissection is acceptable for peripheral squamous T1 tumors, if hilar and interlobar nodes are negative on frozen section studies; it implies removal of, at least, three hilar and interlobar nodes and three mediastinal nodes from three stations in which the subcarinal is always included. Selected lymph node biopsies and sampling are justified to prove nodal involvement when resection is not possible. Pathologic evaluation includes all lymph nodes resected separately and those remaining in the lung specimen. Sections are done at the site of gross abnormalities. If macroscopic inspection does not detect any abnormal site, 2-mm slices of the nodes in the longitudinal plane are recommended. Routine search for micrometastases or isolated tumor cells in hematoxylin-eosin negative nodes would be desirable. Randomized controlled trials to evaluate adjuvant therapies for patients with these conditions are recommended. The adherence to these guidelines will standardize the intraoperative lymph node staging and pathologic evaluation, and improve pathologic staging, which will help decide on the best adjuvant therapy.
URI: 
ISSN: 1010-7940
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Thoracic Surgery
× corresponding author
# (joint) last author

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