Unless I see, I will not believe

Lymph node status is currently one of the most important prognostic factors for the management of non-small cell lung cancer (NSCLC). According to the current guidelines (1), in case of clinical N2 or N3, patients are not candidate to surgery and they are referred to neoadjuvant or definitive chemotherapy and/or radiotherapy, meanwhile in case of clinical N0/N1 surgery is the treatment of choice. Nonetheless, the definition of both N1 and N2 is still based only on merely anatomical criteria and they therefore enclose a wide range of different pathological situations with different prognosis (2). Moreover, the extent of lymph-node dissection has been debated, but to date no strong evidences are available to support one technique or another.