Selective mediastinal lymph node dissection: Precision surgery in the era of precision medicine
- VernacularTitle:选择性纵隔淋巴结清扫：精准医学时代的精准手术
- Author:
Chaoqiang DENG
1
,
2
,
3
,
4
;
Chenyu JIANG
1
,
2
,
3
,
4
;
Yang ZHANG
1
,
2
,
3
,
4
;
Haiquan CHEN
1
,
2
,
3
,
4
Author Information
1. 1. Department of Thoracic Surgery, Cancer Center, Fudan University, Shanghai, 200032, P. R. China
2. 2. State Key Laboratory of Genetic Engineering, Cancer Center, Fudan University, Shanghai, 200032, P. R. China
3. 3. Institute of Thoracic Oncology, Fudan University, Shanghai, 200032, P. R. China
4. 4. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P. R. China
- Publication Type:Journal Article
- Keywords:
Selective lymph node dissection;
precision medicine;
precision surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(09):1224-1227
- CountryChina
- Language:Chinese
-
Abstract:
Along with the popularity of low-dose computed tomography lung cancer screening, an increasing number of early-stage lung cancers are detected. Radical lobectomy with systematic nodal dissection (SND) remains the standard-of-care for operable lung cancer patients. However, whether SND should be performed on non-metastatic lymph nodes remains controversy. Unnecessary lymph node dissection can increase the difficulty of surgery while also causing additional surgical damage. In addition, non-metastatic lymph nodes have been recently reported to play a key role in immunotherapy. How to reduce the surgical damage of mediastinal lymph node dissection for early-stage lung cancer patients is pivotal for modern concept of "minimally invasive surgery for lung cancer 3.0". The selective mediastinal lymph node dissection strategy aims to dissect lymph nodes with tumor metastasis while preserving normal mediastinal lymph nodes. Previous studies have shown that combination of specific tumor segment site, radiology and intraoperative frozen pathology characteristics can accurately predict the pattern of mediastinal lymph node metastasis. The personalized selective mediastinal lymph node dissection strategy formed from this has been successfully validated in a recent prospective clinical trial, providing an important basis for early-stage lung cancer patients to receive more personalized selective lymph node dissection with "precision surgery" strategies.
