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Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer.

Publication ,  Journal Article
Um, S-W; Kim, HK; Jung, S-H; Han, J; Lee, KJ; Park, HY; Choi, YS; Shim, YM; Ahn, M-J; Park, K; Ahn, YC; Choi, JY; Lee, KS; Suh, GY; Kim, J ...
Published in: J Thorac Oncol
February 2015

INTRODUCTION: Correct mediastinal staging is critical for determination of the most appropriate management strategy in patients with non-small-cell lung cancer (NSCLC). The purpose of this study was to compare the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with that of mediastinoscopy in patients with NSCLC. METHODS: A prospective trial was conducted in a tertiary referral center in Korea. Patients with histologically proven NSCLC and suspicion for N1, N2, or N3 metastasis were enrolled. Each patient underwent EBUS-TBNA followed by mediastinoscopy. Surgical resection and complete lymph node dissection were conducted in patients for whom no evidence of mediastinal metastasis was apparent after mediastinoscopy. RESULTS: In total, 138 patients underwent EBUS-TBNA and 127 completed both EBUS-TBNA and mediastinoscopy. N2/N3 disease was confirmed in 59.1% of the patients. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (NPV) of EBUS-TBNA on a per-person analysis were 88.0%, 100%, 92.9%, 100%, and 85.2%, respectively. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and NPV of mediastinoscopy on a per-person analysis were 81.3%, 100%, 89.0%, 100%, and 78.8%, respectively. Significant differences in the sensitivity, accuracy, and NPV were evident between EBUS-TBNA and mediastinoscopy (p < 0.005). CONCLUSIONS: EBUS-TBNA was superior to mediastinoscopy in terms of its diagnostic performance for mediastinal staging of cN1-3 NSCLC. Because EBUS-TBNA is both less invasive and affords superior diagnostic sensitivity, it should be the first-line procedure performed in patients with NSCLC.

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Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

February 2015

Volume

10

Issue

2

Start / End Page

331 / 337

Location

United States

Related Subject Headings

  • Prospective Studies
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Mediastinum
  • Mediastinoscopy
  • Male
  • Lymph Nodes
  • Lung Neoplasms
  • Humans
 

Citation

APA
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Um, S.-W., Kim, H. K., Jung, S.-H., Han, J., Lee, K. J., Park, H. Y., … Kim, H. (2015). Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer. J Thorac Oncol, 10(2), 331–337. https://doi.org/10.1097/JTO.0000000000000388
Um, Sang-Won, Hong Kwan Kim, Sin-Ho Jung, Joungho Han, Kyung Jong Lee, Hye Yun Park, Yong Soo Choi, et al. “Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer.J Thorac Oncol 10, no. 2 (February 2015): 331–37. https://doi.org/10.1097/JTO.0000000000000388.
Um S-W, Kim HK, Jung S-H, Han J, Lee KJ, Park HY, et al. Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer. J Thorac Oncol. 2015 Feb;10(2):331–7.
Um, Sang-Won, et al. “Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer.J Thorac Oncol, vol. 10, no. 2, Feb. 2015, pp. 331–37. Pubmed, doi:10.1097/JTO.0000000000000388.
Um S-W, Kim HK, Jung S-H, Han J, Lee KJ, Park HY, Choi YS, Shim YM, Ahn M-J, Park K, Ahn YC, Choi JY, Lee KS, Suh GY, Chung MP, Kwon OJ, Kim J, Kim H. Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer. J Thorac Oncol. 2015 Feb;10(2):331–337.
Journal cover image

Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

February 2015

Volume

10

Issue

2

Start / End Page

331 / 337

Location

United States

Related Subject Headings

  • Prospective Studies
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Mediastinum
  • Mediastinoscopy
  • Male
  • Lymph Nodes
  • Lung Neoplasms
  • Humans