The Role of Lymphadenectomy in Early-Stage NSCLC

SIMPLE SUMMARY: The extension of lymph node dissection in the treatment of early-stage non-small cell lung cancer (NSCLC) is currently a controversial argument in the scientific community. There are few studies that look at the role of lymphadenectomy in exclusively stage I NSCLC, and in them the lymph node evaluation method is not standardized, avoiding the comparison between different studies. The future perspectives on this issue will need to focus on the necessity of carrying out more precise investigations into the propagation of micrometastases in lung cancer and the application of the latest available techniques for their detection, resulting in a reduction in both local and distant recurrence. ABSTRACT: Lung cancer remains the leading cause of cancer-related death worldwide. The involvement of lymph nodes by the tumor has a strong impact on survival of patients. For this reason, lymphadenectomy plays a crucial role in the staging and prognosis of NSCLC, to define the most appropriate therapeutic strategies concerning the stage of the disease. To date, the benefit, in terms of survival, of the different extents of lymphadenectomy remains controversial in the scientific community. It is recognized that metastatic involvement of mediastinal lymph nodes in lung cancer is one of the most significant prognostic factors, in terms of survival, and it is therefore mandatory to identify patients with lymph node metastases who may benefit from adjuvant therapies, to prevent distant disease and local recurrences. The purpose of this review is to evaluate the role of lymphadenectomy in early-stage NSCLC in terms of efficacy and accuracy, comparing systematic, sampling, and lobe-specific lymph node dissection and analyzing the existing critical issue, through a search of the most relevant articles published in the last decades.