RADICAL SYSTEMATIC MEDIASTINAL LYMPHADENECTOMY IN NONSMALL CELL LUNG-CANCER - A RANDOMIZED CONTROLLED TRIAL

The value of radical systematic lymphadenectomy in the treatment of br onchial carcinoma is controversial. In a randomized controlled clinica l trial, radical lymphadenectomy was compared with conventional node d issection in 182 patients with non-small cell lung cancer. Comparison of short-term results revealed a significantly longer operating time i n those undergoing systematic lymphadenectomy, but overall morbidity a nd mortality rates were comparable between groups. However, there were complications associated with radical lymphadenectomy such as prolong ed air leakage and haemorrhage. Interim analysis of results at a media n follow-up of 26.8 months showed no significant influence of radical lymphadenectomy on local recurrence-free interval, metastasis-free int erval or cancer-related survival. In conclusion, radical systematic ly mphadenectomy is a safe operation that leads to a better staging of no n-small cell lung cancer, but its prognostic benefit is questionable.