{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:56:37Z","timestamp":1772013397437,"version":"3.50.1"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Systematic lymph node dissection (SLND) is currently the gold standard for lung cancer surgery. However, this is not the case for breast cancer or melanoma, where sentinel lymph node (SLN) identification is routine. The SLN could be a possible surrogate for the pathological status of the other lymph nodes, but there is limited data in the literature for lung cancer surgery. The main objective of this study was to evaluate pathological concordance between the SLN and the complete lymphadenectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, we reviewed all cases of localized lung cancer that had benefited from our SLN identification protocol and underwent surgery (segmentectomy or lobectomy) between December 2020 and December 2023. We examined the pathological status of the SLN and the rest of the lymph node dissection to assess the pathological concordance rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After exclusion, 106 patients with localized stage I-IIA non-small cell lung cancer and suspected node negative disease (N0) were included in our study. Of these 106 patients, 96 had a pN0 SLN (90.6%) and 10 had a positive SLN (pN+), resulting in an upstaging rate of 9.4%. All patients with a pN0 SLN were also pN0 for the rest of the lymph node dissection, corresponding to a pathological concordance rate of 100%. Disease-free survival was statistically lower in the pN+ SLN group than in the pN0 SLN group (p&amp;lt;0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrated a 100% pathological concordance between SLN when it is cancer-free and the rest of the lymph nodes in the lymph node dissection, suggesting that the SLN is a good indicator of the overall pathological status of the other lymph nodes in the thorax.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1474887","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T05:14:35Z","timestamp":1741929275000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Sentinel lymph node detection for lung cancer surgery: a possible pathological surrogate of overall lymph node dissection"],"prefix":"10.3389","volume":"15","author":[{"given":"Florent","family":"Stasiak","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Seitlinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyndon C.","family":"Walsh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Streit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joelle","family":"Siat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Gauchotte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucie","family":"Schnedecker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Renaud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.canrad.2006.07.005","article-title":"Lung cancer and lymph drainage","volume":"11","author":"Riquet","year":"2007","journal-title":"Cancer Radiother"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.08.008","article-title":"ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer","volume":"30","author":"Lardinois","year":"2006","journal-title":"Eur J Cardiothorac Surg"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2004.12.035","article-title":"Does the extent of lymph node dissection influence outcome in patients with stage I non-small-cell lung cancer","volume":"27","author":"Doddoli","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2022.01.006","article-title":"Sentinel lymph node methods in breast cancer","volume":"52","author":"Giammarile","year":"2022","journal-title":"Semin Nucl Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/his.15011","article-title":"Sentinel lymph node assessment in melanoma: current state and future directions","volume":"83","author":"Cheng","year":"2023","journal-title":"Histopathology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.35.2500","article-title":"Occult metastases in lymph nodes predict survival in resectable non-small-cell lung cancer: report of the ACOSOG Z0040 trial","volume":"29","author":"Rusch","year":"2011","journal-title":"J Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1097\/JTO.0000000000000559","article-title":"The IASLC lung cancer staging project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer","volume":"10","author":"Rami-Porta","year":"2015","journal-title":"J Thorac Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.05.072","article-title":"Developing intrathoracic sentinel lymph node mapping with near-infrared fluorescent imaging in non\u2013small cell lung cancer","volume":"144","author":"Gilmore","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(99)70415-0","article-title":"Intraoperative lymphatic mapping for non-small cell lung cancer: the sentinel node technique","volume":"117","author":"Little","year":"1999","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1097\/JTO.0b013e318194a2c3","article-title":"Intraoperative sentinel node mapping with technitium-99 in lung cancer: results of CALGB 140203 multicenter phase II trial","volume":"4","author":"Liptay","year":"2009","journal-title":"J Thorac Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2009.11.006","article-title":"Sentinel node mapping in lung cancer: the Japanese experience","volume":"21","author":"Nomori","year":"2009","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004176","article-title":"Finding the \u2018True\u2019 N0 cohort: technical aspects of near-infrared sentinel lymph node mapping in non-small cell lung cancer","volume":"272","author":"Phillips","year":"2020","journal-title":"Ann Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3390\/jpm13010090","article-title":"Sentinel lymph node in non-small cell lung cancer: assessment of feasibility and safety by near-infrared fluorescence imaging and clinical consequences","volume":"13","author":"Stasiak","year":"2022","journal-title":"J Pers Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1078606","DOI":"10.3389\/fonc.2022.1078606","article-title":"What is the appropriate \u2018first lymph node\u2019 in the era of segmentectomy for non-small cell lung cancer","volume":"12","author":"Seitlinger","year":"2022","journal-title":"Front Oncol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s13019-024-02632-y","article-title":"Clinicopathological factors associated with sentinel lymph node detection in non-small-cell lung cancer","volume":"19","author":"Wollbrett","year":"2024","journal-title":"J Cardiothorac Surg"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.bulcan.2017.01.001","article-title":"Review of national and international guidelines for sentinel lymph node biopsy and complementary axillary dissection in breast cancer","volume":"104","author":"Vincent","year":"2017","journal-title":"Bull Cancer"},{"key":"B18","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/cncr.v106:1","article-title":"Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis","volume":"106","author":"Kim","year":"2006","journal-title":"Cancer"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu028","article-title":"Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer","volume":"45","author":"De Leyn","year":"2014","journal-title":"Eur J Cardiothorac Surg"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2018170081","article-title":"Revisions to the TNM staging of lung cancer: rationale, significance, and clinical application","volume":"38","author":"Carter","year":"2018","journal-title":"Radiographics"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02333-3","article-title":"Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802\/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial","volume":"399","author":"Saji","year":"2022","journal-title":"Lancet"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.13737","article-title":"Long-term outcomes of sentinel node identification using indocyanine green in patients with lung cancer","volume":"12","author":"Kawakami","year":"2021","journal-title":"Thorac Cancer"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.09.150","article-title":"Long-term outcomes after near-infrared sentinel lymph node mapping in non-small cell lung cancer","volume":"155","author":"Digesu","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"112817","DOI":"10.1016\/j.biopha.2022.112817","article-title":"Lymph node micrometastasis in non-small cell lung cancer","volume":"149","author":"Sun","year":"2022","journal-title":"BioMed Pharmacother"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2012.880","article-title":"Lymph node micrometastases detected by carcinoembryonic antigen mRNA affect long-term survival and disease-free interval in early-stage lung cancer patients","volume":"4","author":"Nosotti","year":"2012","journal-title":"Oncol Lett"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2023.01.009","article-title":"Axillary lymph node dissection: Dead or still alive","volume":"69","author":"Beck","year":"2023","journal-title":"Breast"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1803290","article-title":"Lymphedema after breast cancer treatment","volume":"379","author":"Rockson","year":"2018","journal-title":"N Engl J Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.28.2491","article-title":"Patient-reported outcomes in sentinel node-negative adjuvant breast cancer patients receiving sentinel-node biopsy or axillary dissection: National Surgical Adjuvant Breast and Bowel Project phase III protocol B-32","volume":"28","author":"Land","year":"2010","journal-title":"J Clin Oncol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.07.4062","article-title":"Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011","volume":"25","author":"Lucci","year":"2007","journal-title":"J Clin Oncol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70207-2","article-title":"Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial","volume":"11","author":"Krag","year":"2010","journal-title":"Lancet Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-012-0416-4","article-title":"The changing role of axillary lymph node dissection for breast cancer","volume":"20","author":"Noguchi","year":"2013","journal-title":"Breast Cancer"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.11470","article-title":"Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (Alliance) randomized clinical trial","volume":"318","author":"Giuliano","year":"2017","journal-title":"JAMA"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30380-2","article-title":"Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial","volume":"19","author":"Galimberti","year":"2018","journal-title":"Lancet Oncol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.bulcan.2019.09.005","article-title":"Strategies in case of metastatic sentinel lymph node in breast cancer","volume":"107","author":"Costaz","year":"2020","journal-title":"Bull Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-014-0412-z","article-title":"Lymph node dissection for lung cancer: past, present, and future","volume":"62","author":"Watanabe","year":"2014","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.09.078","article-title":"Selective mediastinal lymphadenectomy for clinico-surgical stage I non-small cell lung cancer","volume":"81","author":"Okada","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"B37","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.jtho.2023.09.1443","article-title":"A shift in paradigm: selective lymph node dissection for minimizing oversurgery in early stage lung cancer","volume":"19","author":"Jiang","year":"2024","journal-title":"J Thorac Oncol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.4161\/onci.20493","article-title":"Tumor cells, rather than dendritic cells, deliver antigen to the lymph node for cross-presentation","volume":"1","author":"McDonnell","year":"2012","journal-title":"Oncoimmunology"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-021-02934-3","article-title":"Tumour draining lymph node-generated CD8 T cells play a role in controlling lung metastases after a primary tumour is removed but not when adjuvant immunotherapy is used","volume":"70","author":"Fear","year":"2021","journal-title":"Cancer Immunol Immunother"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000774","article-title":"Impact of lymphadenectomy extent on immunotherapy efficacy in postresectional recurred non-small cell lung cancer: a multi-institutional retrospective cohort study","volume":"110","author":"Deng","year":"2024","journal-title":"Int J Surg"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02098-5","article-title":"Adjuvant atezolizumab after adjuvant chemotherapy in resected stage IB-IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial","volume":"398","author":"Felip","year":"2021","journal-title":"Lancet"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2022-005160","article-title":"Response of primary tumor and lymph node in non-small cell lung cancer after neoadjuvant immunotherapy: a pooled analysis","volume":"10","author":"Zhai","year":"2022","journal-title":"J Immunother Cancer"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyad125","article-title":"Neoadjuvant versus adjuvant systemic therapy for early-stage non-small cell lung cancer: the changing landscape due to immunotherapy","volume":"28","author":"John","year":"2023","journal-title":"Oncologist"},{"key":"B44","doi-asserted-by":"publisher","first-page":"16073","DOI":"10.1038\/ncomms16073","article-title":"Enhanced anti-tumour immunity requires the interplay between resident and circulating memory CD8+ T cells","volume":"8","author":"Enamorado","year":"2017","journal-title":"Nat Commun"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2022.07.042","article-title":"Lobe-specific lymph node dissection in early-stage non-small-cell lung cancer: An overview","volume":"46","author":"Peng","year":"2023","journal-title":"Asian J Surg"},{"key":"B46","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1016\/S0140-6736(22)01694-4","article-title":"Lung cancer screening","volume":"401","author":"Adams","year":"2023","journal-title":"Lancet"},{"key":"B47","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.lungcan.2004.03.008","article-title":"In vivo identification of sentinel lymph nodes for clinical stage I non-small cell lung cancer for abbreviation of mediastinal lymph node dissection","volume":"46","author":"Nomori","year":"2004","journal-title":"Lung Cancer"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.03.059","article-title":"Intraoperative sentinel lymph node mapping in stage I non-small cell lung cancer: detection of micrometastases by polymerase chain reaction","volume":"34","author":"Melfi","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1126\/sciimmunol.abg3551","article-title":"Tumor-draining lymph nodes: At the crossroads of metastasis and immunity","volume":"6","author":"du Bois","year":"2021","journal-title":"Sci Immunol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1474887\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T05:14:38Z","timestamp":1741929278000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1474887\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,14]]},"references-count":49,"alternative-id":["10.3389\/fonc.2025.1474887"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1474887","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,14]]},"article-number":"1474887"}}