The following is a summary of “A National Survey of Surgeons Evaluating the Accuracy of Mediastinal Lymph Node Identification,” published in the July 2023 issue of the Clinical Lung Cancer by Yang et al.
Standard 5.8 was implemented by the Commission on Cancer in 2021, requiring the excision of three mediastinal lymph nodes and one hilar lymph node during lung cancer resection. Researchers administered a national survey to determine whether surgeons who treat lung cancer in various clinical settings correctly identify mediastinal lymph node stations. On the Cardiothoracic Surgery Network, cardiac or thoracic surgeons interested in lung cancer surgery were asked to complete a 7-question survey assessing their knowledge of lymph node anatomy.
Thoracic surgery-practicing general surgeons were invited through the Cancer Research Program of the American College of Surgeons. The results were analyzed using the chi-square test developed by Pearson. Using multivariable linear regression, predictors of a higher survey score were identified. The median age of the 280 surgeons who responded was 50 years; 86.8% were male, and 13.2% were female. About 211 (75.4%) of these surgeons were thoracic surgeons, 59 (21.1%) were cardiac surgeons, and 10 (3.6%) were general surgeons. Surgeons were most likely to accurately identify lymph node stations 8R and 9R and least likely to correctly identify the paratracheal node just superior to the carina in the midline (4R).
Surgeons whose practices included a more significant proportion of thoracic surgery patients and lobectomies rated higher on the lymph node evaluation. Knowledge of mediastinal node anatomy is generally high among thoracic surgeons but varies depending on the clinical setting. Efforts are being made to better educate lung cancer surgeons on nodal anatomy and increase Standard 5.8 adoption.
Source: sciencedirect.com/science/article/pii/S1525730423000451