Multicenter phase 3 trial of value of mediastinal lymph node dissection in ground glass opacity-dominant lung adenocarcinoma

A multicenter phase 3 noninferiority study evaluated avoidance of systematic mediastinal lymph node dissection (LND) in patients with ground glass opacity (GGO)-dominant invasive lung adenocarcinoma. Patients were randomized to LND or no LND. Interim analysis of the trial found no lymph node metastasis in either arm. The no LND arm had significantly reduced surgery duration, blood loss, and postoperative hospital stay. Complications in the systemic LND arm included cyclothorax in one patient and intraoperative massive bleeding in one patients. No lymphadenectomy-related complications occurred in the no LND arm. The authors conclude that systematic mediastinal LND should no longer be recommended for patients with GGO-dominant lung adenocarcinoma.