Examined lymph node count in non-small-cell lung cancer: will it be a decision making approach in treatment of NSCLC?

Surgical therapy, which accurate staging and pathological diagnosis relay on, is still irreplaceable in the treatment strategy of lung cancer, especially for the early stage non-small-cell lung cancer (NSCLC) (1). Besides resection of tumors, many prognostic factors, including nodal status, histology, and tumor size, can be provided through surgical procedure. Nodal status, as one of the most important factors in the staging definition and adjuvant chemotherapy selection, has always been playing a significant role in the heath care of lung cancer patients (2). However, differing from gastrointestinal and breast cancer, the recommendation of lymph node (LN) dissection or examinations from NCCN is in the qualitative level and the studies focus on the examined lymph nodes (ELNs) is still insufficient in lung cancer (1,3,4). Thus, Liang et al. investigated the effect of ELNs in the staging and prognosis of NSCLC in a real-world retrospective analysis, which tried to provide a reliable evidence of LN management in the quantitative level for NSCLC patients (5)