Reply to Letter to the Editor

摘要

In our opinion, the nodal removal in stage I patients has two advantages: First, complete mediastinal lymphadenectomy provides the best possibility for accurate tumor staging in patients with pathologically proven lymph node negative non-small cell lung cancer (NSCLC).1"4 If a lymph node is not removed for histological examination, we cannot know whether it is pathologically metastatic or not. Second, the nodal removal may improve the survival. One of the possible explanations is the micrometastasis in the "negative lymph node."5'6 A higher number of lymph nodes removed was associated with statistically significant improvements in OS7 But the therapeutic role of lymph node removal in stage I NSCLC needs to be proven by a prospective randomized clinical trial.