AI Article Synopsis

  • The study aimed to improve the pathologic staging of mediastinal lymph nodes (MLNs) in patients with non-small-cell lung cancer by using a specialized specimen-collection kit.
  • The results showed a significant increase in the number of MLNs examined and a higher percentage of resections meeting quality standards for pathology compared to controls, with no increase in surgery duration or complications.
  • The use of the kit not only improved MLN staging but also suggested a trend toward better detection of metastatic cases, potentially impacting post-surgery treatment options.

Article Abstract

Introduction: Pathologic examination of mediastinal lymph nodes (MLNs) after resection of non-small-cell lung cancer is critical in the determination of prognosis and postoperative management. Although systematic nodal dissection is recommended, the quality of pathologic lymph-node staging often falls short of recommendations in practice. We tested the feasibility of improving pathologic lymph-node staging of resectable non-small-cell lung cancer by using a prelabeled specimen-collection kit.

Methods: Case-control study with comparison of 51 resections, using a special lymph-node collection kit, with 51 controls matched for surgeon, extent of resection, pathologist, and T category. Appropriate statistical methods were used for all comparisons.

Results: The median number of MLNs examined increased from one in the control group, to six in the case group (p < 0.001). The percentage of resections attaining the National Comprehensive Cancer Network-recommended quality of MLN examination, and the proportion that would have been eligible for recent landmark postresection adjuvant therapy trials increased significantly (p < 0.001). The duration of surgery and postoperative complication rates were similar between cases and controls. Eighteen percent of kit cases had positive MLN, compared with 8% of controls.

Conclusions: The use of a specialized specimen-collection kit for MLN examination was feasible, markedly improved MLN staging, and showed a trend toward increased detection of patients with MLN metastasis, with only a modest increase in duration of surgery, and no increase in perioperative morbidity, mortality, or hospital length of stay.

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Source
http://dx.doi.org/10.1097/JTO.0b013e318257fbe5DOI Listing

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