Intratumoral lymph vessel invasion as a predictive risk factor for nodal metastasis in non-small cell lung cancer: should L-1 status obligate adjuvant chemotherapy?

The presence of lymph node involvement has long been established as a critical prognostic factor and principal determinant of adjuvant therapy in the treatment of non-small cell lung cancer (NSCLC). In the manuscript “Predictive risk factors for lymph node metastasis in patients with resected non-small cell lung cancer: a case control study”, Moulla and colleagues present an analysis of data collected over nearly a decade with the goal of determining both pre- and postoperative predictors for nodal metastasis (1). The authors propose two approaches for predicting nodal involvement: a preoperative model based on radiology and bronchoscopic evaluation, and a post-operative model based on pathologic analysis of the resected specimen.