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Abstract
Introduction. Systematization of data on the pathways of lymphogenic metastasis, the frequency of lesions of various groups of lymph nodes in the lung and mediastinum, as well as the definition of groups of lymph nodes, removal of which does not increase the oncological benefit to the patient and can be revised.
Materials and Methods. This retrospective study was conducted from November 2021 to September 2023 at the Department of Thoracic Oncology, N.N. Petrov National Medical Research Centre for Oncology. The study was conducted after the local ethical committee gave its approval. Samples were collected from all patients who underwent surgery for non-small cell lung cancer (NSCLC) and had pN1-pN3 according to the results of a planned pathomorphology study. The analysis included 272 people.
Results. Data were obtained and presented on the frequency of involvement of each group of pulmonary and mediastinal lymph nodes according to the lobular location of the primary tumor. Based on the data obtained, models of optimized lob-specific lymphatic dissection with minimal risk of leaving metastatic lymph nodes in the patient's body have been developed.
Conclusion. There is a pattern of metastatic lesion of the lymphatic collectors of the lung and mediastinum for each lobe of the right and left lung in NSCLC. The proposed model of lobe-specific lymph node dissection, based on data from routine preoperative noninvasive staging in a highly specialized hospital, can be considered to reduce operative time and surgical trauma in patients with NSCLC (cT<2aN0) with limited functional reserves and for further prospective study. It is also important to emphasize the need for mandatory removal of group #3a when performing ipsilateral lymphatic dissection with primary tumor localization in the upper and middle lobes.
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