title: Rethinking N2 disease in the era of uniportal video-assisted thoracic surgery.
abstract: Third Mediterranean Symposium on Thoracic Surgical Oncology, Catania, Italy, 21-22 April 2016 The primary justification for mediastinal lymphadenectomy is that it provides more complete nodal staging to help select best adjuvant treatments. There is a secondary argument that dissection of nodes might remove otherwise unrecognized nodal disease to increase the chance of cure. They have to be thought through again as patients look for less invasive treatments for their cancers such as videothoracoscopy and stereotactic radiotherapy. Evidence from analysis of Surveillance, Epidemiology and End Results data indicated that sampling or dissection can be performed adequately by surgeons using videothoracoscopy but stereotactic radiotherapy of its nature precludes intraoperative lymph node dissection and yet is being promoted as equivalent treatment. Consideration of these issues requires re-examination of the evidence that lymphadenectomy influences survival.
authors.affiliation: Clinical Operational Research Unit, University College London, London, WC1H 0BT, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Treasure
authors.affiliation: Department of Thoracic Surgery, University Hospitals Leuven, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: De Leyn
mesh_terms: D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum / Q000473:pathology*; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*
keywords: VATS; lung cancer; lymphadenectomy; staging; videothoracoscopic surgery