Rebuttal from Dr. Decaluwé and Dr. Dooms

Herbert Decaluwé, Christophe Dooms


We congratulate Drs. Obiols and Call for their excellent argumentations to consider a preoperative exploration of the mediastinal lymph nodes in order to avoid futile anatomical lung resections. As they rightly pointed out, preoperative invasive mediastinal nodal staging is not routinely indicated in clinical stage IA non-small cell lung cancer (cStage-IA NSCLC). Nevertheless, the authors suggested specific indications in which preoperative invasive mediastinal nodal staging might be indicated for cStage-IA NSCLC: centrally located tumor; adenocarcinoma histology; high FDG-uptake on PET; tumor size (≤2 cm vs. 2.1–3.0 cm); or a combination of these factors.