Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study
<p>Abstract</p> <p>Background</p> <p>At present only few studies directly compare the diagnostic yield of endobronchial ultrasound guided fine needle aspiration (EBUS-FNA) and transcervical video-assisted mediastinoscopy (TM) for mediastinal lymph node staging in patien...
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doaj-cf02a0b59e7a4a3a96f8821531132eb92020-11-25T02:27:43ZengBMCJournal of Cardiothoracic Surgery1749-80902012-06-01715110.1186/1749-8090-7-51Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison studyZhang RuoyuMietchen ChristinaKrüger MarcusWiegmann BettinaGolpon HeikoDettmer SabineHaverich AxelZardo Patrick<p>Abstract</p> <p>Background</p> <p>At present only few studies directly compare the diagnostic yield of endobronchial ultrasound guided fine needle aspiration (EBUS-FNA) and transcervical video-assisted mediastinoscopy (TM) for mediastinal lymph node staging in patients with NSCLC. If and when EBUS-FNA may replace TM as Gold Standard remains controversial.</p> <p>Methods</p> <p>From April 2008 to December 2009, 36 patients with mediastinal lymphadenopathy underwent simultaneous EBUS-FNA/ TM at our institution. Among them were 26 patients with confirmed or suspected NSCLC.</p> <p>Results</p> <p>A total of 133 samples were obtained by EBUS-FNA and 157 samples by TM. EBUS-FNA achieved significantly less conclusive, but more indeterminate pathological results in comparison to TM (78.7% vs. 98.6%, <it>p</it> < 0.001; 14.9% vs. 1.4%, <it>p</it> = 0.007). Less paratracheal nodes were sampled by EBUS-FNA (right: 46.2% vs. 88.5%, <it>p</it> = 0.003; left: 23.1% vs. 65.4%, <it>p</it> = 0.005), while sampling rates in the subcarinal localisation were comparable (96.2% vs. 80.8%, <it>p</it> = NS). Among patients with confirmed NSCLC and conclusive EBUS-FNA/ TM findings (n = 18), the prevalence of N2/N3 disease was 66.7% (n = 12) according to TM findings. Diverging nodal stages were found in five patients (27.8%). Three patients who were N2 negative in EBUS-FNA were upstaged to N2 or N3 by TM, two patients with N2 status in EBUS-FNA were upstaged to N3 by TM.</p> <p>Conclusions</p> <p>Compared to TM, EBUS-FNA had a lower diagnostic yield and resulted in systematic mediastinal nodal understaging. At this point we suggest corroborating negative EBUS-FNA results by transcervical mediastinoscopy.</p> http://www.cardiothoracicsurgery.org/content/7/1/51EBUS-FNAMediastinoscopyNSCLCNodal staging |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zhang Ruoyu Mietchen Christina Krüger Marcus Wiegmann Bettina Golpon Heiko Dettmer Sabine Haverich Axel Zardo Patrick |
spellingShingle |
Zhang Ruoyu Mietchen Christina Krüger Marcus Wiegmann Bettina Golpon Heiko Dettmer Sabine Haverich Axel Zardo Patrick Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study Journal of Cardiothoracic Surgery EBUS-FNA Mediastinoscopy NSCLC Nodal staging |
author_facet |
Zhang Ruoyu Mietchen Christina Krüger Marcus Wiegmann Bettina Golpon Heiko Dettmer Sabine Haverich Axel Zardo Patrick |
author_sort |
Zhang Ruoyu |
title |
Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study |
title_short |
Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study |
title_full |
Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study |
title_fullStr |
Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study |
title_full_unstemmed |
Endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study |
title_sort |
endobronchial ultrasound guided fine needle aspiration versus transcervical mediastinoscopy in nodal staging of non small cell lung cancer: a prospective comparison study |
publisher |
BMC |
series |
Journal of Cardiothoracic Surgery |
issn |
1749-8090 |
publishDate |
2012-06-01 |
description |
<p>Abstract</p> <p>Background</p> <p>At present only few studies directly compare the diagnostic yield of endobronchial ultrasound guided fine needle aspiration (EBUS-FNA) and transcervical video-assisted mediastinoscopy (TM) for mediastinal lymph node staging in patients with NSCLC. If and when EBUS-FNA may replace TM as Gold Standard remains controversial.</p> <p>Methods</p> <p>From April 2008 to December 2009, 36 patients with mediastinal lymphadenopathy underwent simultaneous EBUS-FNA/ TM at our institution. Among them were 26 patients with confirmed or suspected NSCLC.</p> <p>Results</p> <p>A total of 133 samples were obtained by EBUS-FNA and 157 samples by TM. EBUS-FNA achieved significantly less conclusive, but more indeterminate pathological results in comparison to TM (78.7% vs. 98.6%, <it>p</it> < 0.001; 14.9% vs. 1.4%, <it>p</it> = 0.007). Less paratracheal nodes were sampled by EBUS-FNA (right: 46.2% vs. 88.5%, <it>p</it> = 0.003; left: 23.1% vs. 65.4%, <it>p</it> = 0.005), while sampling rates in the subcarinal localisation were comparable (96.2% vs. 80.8%, <it>p</it> = NS). Among patients with confirmed NSCLC and conclusive EBUS-FNA/ TM findings (n = 18), the prevalence of N2/N3 disease was 66.7% (n = 12) according to TM findings. Diverging nodal stages were found in five patients (27.8%). Three patients who were N2 negative in EBUS-FNA were upstaged to N2 or N3 by TM, two patients with N2 status in EBUS-FNA were upstaged to N3 by TM.</p> <p>Conclusions</p> <p>Compared to TM, EBUS-FNA had a lower diagnostic yield and resulted in systematic mediastinal nodal understaging. At this point we suggest corroborating negative EBUS-FNA results by transcervical mediastinoscopy.</p> |
topic |
EBUS-FNA Mediastinoscopy NSCLC Nodal staging |
url |
http://www.cardiothoracicsurgery.org/content/7/1/51 |
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