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 lymph-node staging in lung cancer. The use of a reproducible map is an essential pre-requisite for correct determination of the TNM status and comparing the surgical results. In order to evaluate the current status of lymph-node mapping and lymphnode dissection in Germany, we performed 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 Gefabchirurgie/Pneumologie), 23 % lymph-node mapping according to Naruke, and 25 % an individual description of the resected lymph nodes. The number of resected lymph nodes is reported in 75 % of the departments, the quotient of involved/not involved lymph nodes in 33 %. Mediastinal lymph-node sampling guided by the intraoperative aspect of lymph nodes is performed in 59 % of the departments. A systematic mediastinal ''en-bloc'' resection is accomplished in 41 %. The results of this survey represent 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.