Identifying lymph node involvement with VATs surgery


After VATs wedge surgery for a 1a Squamous nodule in my RLL, the oncology surgeon said that he couldn’t find any lymph nodes to biopsy. The pathology report said the tumor abuts the pleura, but doesn’t infiltrate into it. Surgical resection margins were free of tumor. The tumor had been poorly differentiated, and there was evidence of lympho-vascular invasion.

I believe that the surgeon was saying that there can be areas of the lung where there are no lymph nodes. I know he said that he really spent a long time poking around trying to find some. How would this work with staging?

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GRACE Community Outreach Team

Hi atrooper,

Although it might be good to seek clarification from the surgeon, I think your assumption is correct, that there simply weren’t any lymph nodes near the resected nodule. In the absence of any evidence of enlarged nodes or other indications the cancer has spread, it seems likely the original Ia staging would remain unchanged.

And that’s a great result!

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