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• W1981124580 abstract "Rationale: Staging of non-small cell lung cancer (NSCLC) critically depends on surgical procedures. Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) is an accurate, safe and minimally invasive technique for the analysis of mediastinal lymph nodes and can additionally detect tumour invasion (T4) in patients with centrally located tumours. Objective: The goal of this study was to determine the accuracy of EUS-FNA in the pre-operative staging of NSCLC and to assess its impact on surgical staging. Methods: 101 consecutive patients with proven NSCLC and enlarged (>1 cm) mediastinal lymph nodes at chest CT underwent staging by EUS-FNA. The presence or absence of invasion in mediastinal structures (T4) was recorded. Prior to EUS, patients were scheduled for mediastinoscopy (n = 79), mediastinotomy (n = 14) or exploratory thoracotomy (n = 8). Surgical- pathological verification occurred when EUS-FNA did not demonstrate lymph node metastases or tumour invasion. The proportion of cancelled surgical interventions due to EUS findings was the primary endpoint. Results: EUS-FNA prevented 66% of scheduled surgical procedures. EUS-FNA demonstrated lymph node metastases in 48%, tumour invasion (T4) in 8% and both tumour invasion and lymph node metastases in 10% of patients. Sensitivity, specificity and diagnostic accuracy of EUS-FNA in distinguishing benign from malignant mediastinal lymph nodes were 91%, 100% and 93%. No complications were recorded. Conclusions: EUS-FNA qualifies as the next staging procedure for patients with NSCLC and enlarged mediastinal lymph nodes. Implementation of EUS-FNA in staging algorithms for NSCLC might reduce the number of surgical staging procedures considerably. Rationale: Staging of non-small cell lung cancer (NSCLC) critically depends on surgical procedures. Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) is an accurate, safe and minimally invasive technique for the analysis of mediastinal lymph nodes and can additionally detect tumour invasion (T4) in patients with centrally located tumours. Objective: The goal of this study was to determine the accuracy of EUS-FNA in the pre-operative staging of NSCLC and to assess its impact on surgical staging. Methods: 101 consecutive patients with proven NSCLC and enlarged (>1 cm) mediastinal lymph nodes at chest CT underwent staging by EUS-FNA. The presence or absence of invasion in mediastinal structures (T4) was recorded. Prior to EUS, patients were scheduled for mediastinoscopy (n = 79), mediastinotomy (n = 14) or exploratory thoracotomy (n = 8). Surgical- pathological verification occurred when EUS-FNA did not demonstrate lymph node metastases or tumour invasion. The proportion of cancelled surgical interventions due to EUS findings was the primary endpoint. Results: EUS-FNA prevented 66% of scheduled surgical procedures. EUS-FNA demonstrated lymph node metastases in 48%, tumour invasion (T4) in 8% and both tumour invasion and lymph node metastases in 10% of patients. Sensitivity, specificity and diagnostic accuracy of EUS-FNA in distinguishing benign from malignant mediastinal lymph nodes were 91%, 100% and 93%. No complications were recorded. Conclusions: EUS-FNA qualifies as the next staging procedure for patients with NSCLC and enlarged mediastinal lymph nodes. Implementation of EUS-FNA in staging algorithms for NSCLC might reduce the number of surgical staging procedures considerably." @default.
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• W1981124580 date "2005-04-01" @default.
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• W1981124580 title "Endoscopic Ultrasound in Non-Small Cell Lung Cancer and its Impact on Surgical Staging" @default.
• W1981124580 doi "https://doi.org/10.1016/s0016-5107(05)01406-9" @default.
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