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- Title
Diagnostic performance of endobronchial ultrasound-guided mediastinal lymph node sampling in early stage non-small cell lung cancer: A prospective study.
- Authors
Vial, Macarena R.; O'Connell, Oisin J.; Grosu, Horiana B.; Hernandez, Mike; Noor, Laila; Casal, Roberto F.; Stewart, John; Sarkiss, Mona; Jimenez, Carlos A.; Rice, David; Mehran, Reza; Ost, David E.; Eapen, George A.
- Abstract
ABSTRACT Background and objective Standard nodal staging of lung cancer consists of positron emission tomography/computed tomography ( PET/ CT), followed by endobronchial ultrasound-guided transbronchial needle aspiration ( EBUS-TBNA) if PET/ CT shows mediastinal lymphadenopathy. Sensitivity of EBUS-TBNA in patients with N0/ N1 disease by PET/ CT is unclear and largely based on retrospective studies. We assessed the sensitivity of EBUS-TBNA in this setting. Methods We enrolled patients with proven or suspected lung cancer staged as N0/ N1 by PET/ CT and without metastatic disease ( M0), who underwent staging EBUS-TBNA. Primary outcome was sensitivity of EBUS-TBNA compared with a composite reference standard of surgical stage or EBUS-TBNA stage if EBUS demonstrated N2/ N3 disease. Results Seventy-five patients were included in the analysis. Mean tumour size was 3.52 cm (±1.63). Fifteen of 75 patients (20%) had N2 disease. EBUS-TBNA identified six while nine were only identified at surgery. Sensitivity of EBUS-TBNA for N2 disease was 40% (95% CI: 16.3-67.7%). Conclusion A significant proportion of patients with N0/ N1 disease by PET/ CT had N2 disease (20%) and EBUS-TBNA identified a substantial fraction of these patients, thus improving diagnostic accuracy compared with PET/ CT alone. Sensitivity of EBUS-TBNA however appears lower compared with historical data from patients with larger volume mediastinal disease. Therefore, strategies to improve EBUS-TBNA accuracy in this population should be further explored
- Subjects
LUNG cancer; NON-small-cell lung carcinoma; COMPUTED tomography; MEDIASTINAL tumors; LYMPH nodes
- Publication
Respirology, 2018, Vol 23, Issue 1, p76
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.13162