2024 World Conference on Lung Cancer (WCLC) - Posters-P1.08C.02 Revisiting the ACS 3N2 + 1N1 Mandate: Should Old Data Define Today's Standard?

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The study examines the American College of Surgeons Commission on Cancer's (ACS CoC) mandate that dictates specific requirements for mediastinal lymph node (MLN) examinations during lung cancer surgeries. This mandate requires that surgeries with curative intent involve the sampling of at least one hilar station and three distinct mediastinal stations, a standard rooted in data from an earlier period (1998-2002). The researchers questioned whether such historical data should dictate current medical practices.<br /><br />The study utilized the Surveillance, Epidemiology, and End Results (SEER) database to analyze non-small cell lung cancer cases from 2018 to 2020. They assessed whether the number of MLN examined impacts patient survival rates. The analysis showed that while MLN assessment is associated with improved survival, the number of regional lymph nodes examined was not an independent predictor of survival. However, the number of positive regional lymph nodes was an independent predictor.<br /><br />The findings suggest that the ACS CoC mandate may not effectively address existing challenges in lung cancer surgeries and highlights the need for personalized medicine approaches over broad mandates. The study raises concerns about whether one-size-fits-all solutions are appropriate in modern practice and suggests exploring alternative methods like lobe-specific lymph node dissection.<br /><br />The authors recommend enhanced data collection and a reevaluation of existing standards, emphasizing the importance of adaptable and evidence-based practices that consider contemporary advancements and diverse patient needs. Hence, incorporating insights from recent data and techniques is crucial for establishing more relevant and effective clinical guidelines.

Asset Subtitle

Shubham Gulati

Meta Tag

Speaker Shubham Gulati

Topic Local-Regional NSCLC

Keywords

American College of Surgeons

mediastinal lymph node

lung cancer surgery

Surveillance Epidemiology and End Results

non-small cell lung cancer

patient survival

personalized medicine

lobe-specific lymph node dissection

evidence-based practices

clinical guidelines