In recent years, intraoperative lymph node (LNs) dissection in patients with resectable non-small cell lung cancer (NSCLC) has been a hot topic of discussion. A recent study has shown that radical mediastinal lymphatic node dissection improves patient staging and overall survival compared with harvest-style LNs dissection. In addition, some scholars have observed that more LNs on postoperative pathology in patients with stage I NSCLC may contribute to proper staging and affect prognostic survival. However, most studies confirm that the variability in the number of LNs cleared should be based on the type of study design, tumor stage, and number of lymph node stations. This variability may be related to prognostic value but also to anatomical variability. To analyze the variability in the number of LNs cleared during radical mediastinal lymphatic dissection and its impact on the prognosis of a series of NSCLC procedures, Professor Riquet et al. from the Department of Thoracic Surgery, University of Descartes, Pompidou European Hospital, France, completed the study, which was recently published in the journal ATS. The study prospectively collected and retrospectively collated the number of lung and mediastinal lymph nodes cleared in a total of 1095 patients undergoing lung cancer resection + systemic lymphatic dissection from 2004 to 2009, and analyzed individual differences in the number of responding LNs and the impact on prognostic overall survival (OS) using Gaussian curves. There were 774 male patients; the mean age was 62.6 years. The postoperative complication rate and mortality rate were 26% and 2.7%, respectively; the 5-year OS was 53.8%. The mean number of intraoperatively cleared lung and mediastinal LNs was 17.4±7.3. This number was significantly higher in men, in patients with squamous cell carcinoma, right-sided surgery, lobectomy and pneumonectomy, N stage N2, and stages pII and pIII; there was no significant relationship with age, T stage, or complete clearance. Mediastinal lymph nodes were positive in 202 patients (18%). The mean number of cleared mediastinal LNs was 10.7 ± 5.6, with a normal distribution (as in Figure 1). Figure 1, Distribution of the number of intraoperative cleared mediastinal lymph nodes in 1095 patients with NSCLC. The effect of 5-year OS was significantly correlated with the number of stations of intraoperative lymph node dissection (31.5% and 16.9% for patients with single versus multiple stations of lymph node dissection, respectively; this difference was significant); not the number of LNs dissected, the number of mediastinal LNs dissected, or the number of positive mediastinal LNs. From the results of this study, it appears that the number of LNs cleared for lung cancer resection + radical lymphadenectomy was normally distributed and had no significant effect on postoperative OS. Thus, indicating that the most appropriate number of intraoperative cleared LNs is arbitrary. However, Prof. Riquet’s recommendation is to perform complete radical lung and mediastinal lymph node dissection based on anatomical structures.