LYMPH-NODE STAGING AND LYMPHADENECTOMY IN LUNG-CANCER - RESULTS OF A SURVEY IN GERMANY

A number of different mapping systems have been published for the lymp h-node staging in lung cancer. The use of a reproducible map is an ess ential pre-requisite for correct determination of the TNM status and c omparing the surgical results. In order to evaluate the current status of lymph-node mapping and lymphnode dissection in Germany, we perform ed a mail survey involving 90 hospitals performing operations for lung cancer. Responses were obtained from 61 (67.7 %) hospitals. Currently , the majority of the departments (43 %) use the German staging system (according to the Deutsche Gesellschaft fur Thorax-, Herz- und Gefabc hirurgie/Pneumologie), 23 % lymph-node mapping according to Naruke, an d 25 % an individual description of the resected lymph nodes. The numb er of resected lymph nodes is reported in 75 % of the departments, the quotient of involved/not involved lymph nodes in 33 %. Mediastinal ly mph-node sampling guided by the intraoperative aspect of lymph nodes i s performed in 59 % of the departments. A systematic mediastinal ''en- bloc'' resection is accomplished in 41 %. The results of this survey r epresent the current status of lymph-node mapping and lymphadenectomy in lung cancer in Germany and might be useful for the development of a uniform staging system.