The prognostic significance of mediastinal lymph node (LN) status during pulmonary metastasectomy (PM) remains debated. In a retrospective study of 84 patients, unexpected LN positivity was observed in 15.5%. Survival outcomes sharply diverged: 2-year survival was 71.8% in LN-negative vs. 14.1% in LN-positive patients.
In colorectal carcinoma, LN positivity emerged as a strong predictor of mortality, with nearly a 3-fold higher hazard of death. Interestingly, recurrence rates were similar regardless of LN status, suggesting that LN involvement influences survival more than recurrence dynamics. Despite preoperative CT and PET-CT evaluation, LN metastases were frequently missed, underlining the limitations of imaging alone. The findings reinforce LN assessment as a critical determinant of prognosis and a potential decision-maker in surgical planning for PM, particularly in colorectal…
