Clinically node-negative non-small cell lung cancer (NSCLC) may harbor occult lymph node metastases, yet the optimal extent of lymph node evaluation during surgery remains unclear. To address this gap, a study analyzed the impact of expanded lymph node dissection, particularly assessment of multiple N1 nodes on cancer upstaging in 48,779 patients with NSCLC using data from the Society of Thoracic Surgeons General Thoracic Surgery Database. The study found that expanded lymph node dissection during surgery for clinically node-negative non-small cell lung cancer identified a substantial number of occult metastases, with 11.2% of patients upstaged following pathologic evaluation.
More cancers were detected in N1 than N2 lymph nodes, particularly in N1 nodes adjacent to the bronchi, highlighting the importance of evaluating more than one N1 node. These findings suggest that broader nodal…
