EBUS-TBNA versus surgical mediastinoscopy for mediastinal lymph node staging in potentially operable non-small cell lung cancer: a systematic review and meta-analysis

Figueiredo, Vivíane Rossi; Cardoso, Paulo Francisco Guerreiro; Jacomelli, Márcia; Santos, Lília Maia; Minata, Maurício K.; Terra, Ricardo Mingarini

doi:10.36416/1806-3756/e20190221

Cited by 23 publications

(26 citation statements)

References 30 publications

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“…EBUS-TBNA has become a mature interventional diagnostic procedure in clinical practice. Previous studies showed that no statistically signi cant difference was identi ed between EBUS-TBNA and mediastinoscopy in diagnostic sensitivity to evaluate malignant lymph nodes with previous imaging results indicating the enlargement of mediastinal and/or hilar lymph nodes or adjacent lesions in lungs (Figueiredo et al 2020). However, compared to mediastinoscopy, EBUS-TBNA was a less invasive procedure with low costing and better tolerability for patients (Sampsonas et al 2018;Verdial et al 2020).…”

Section: Discussionmentioning

confidence: 95%

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Huang¹,

Lü²,

Wang³

et al. 2021

Preprint

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Background: Endobronchial ultrasound (EBUS) elastography has been applied in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on the tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely used for onsite evaluation of the adequacy of the samples and guiding the sampling during EBUS-TBNA. The aim of the study is to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating of mediastinal and hilar lymph nodes status.Methods: A retrospective chart review was performed from December 2018 to September 2020. Patients’ demographic, EBUS elastography score, ROSE, pathologic and clinical outcomes were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly non-blue; Type 2, partially blue and partially non-blue; Type 3, predominantly blue. Receiver operating characteristic (ROC) curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio among EBUS elastography, ROSE, and EBUS combined with ROSE groups for evaluation of malignant lymph nodes.Results: A total of 247 patients (345 lymph nodes) were included in our study. The sensitivity and specificity of EBUS elastography group in the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE alone group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE group were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under curve was 0.942.Conclusions: The combination of EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph nodes status.

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Section: Discussionmentioning

confidence: 95%

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Huang¹,

Lü²,

Wang³

et al. 2021

Preprint

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“…This P r e p r i n t 11 misclassified percentage was more than 50% for the left lower paratracheal LNs. Such problem was further studied by EBUS-TBNA, which was recognized as the most diagnostic value in hilar/mediastinal (N1/N2) lymph node staging [17][18][19]. The concordance between these two maps for the left side LNs was poor (Kappa 0.374).…”

Section: Discussionmentioning

confidence: 99%

Demarcated by bronchial or vascular landmarks? a study on the lower borders of the lower paratracheal lymph nodes

et al. 2023

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IntroductionThe lower rim of the azygous arch and the upper rim of the left main pulmonary artery are used as the lower borders of the lower paratracheal lymph nodes (LNs) in the IASLC map. However, there is some confusion about it. Our aim was to investigate the best landmarks as the boundaries to stage N more accurately for lung cancer.Material and methodsOne hundred patients with benign lung diseases, fifty with lung cancer diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), and thirteen with right metastatic LNs confirmed by surgery were included. The lymph nodes (including W1, W3, W5, 10R below W5, W4, W6) were classified with Wang's and IASLC map concurrently, and the different outcomes of N stage were compared.ResultsThe azygous arch and the left main pulmonary artery varied in relation to the airway, causing the following changes of classification, 9.4% benign LNs of W1 and 38.6% of W5 were down-regulated as IASLC-10R, 9.5% of 10R below W5 were up-regulated as IASLC-4R, 51.4% of W4 and 94% of W6 were down-regulated as IASLC-10L. In 50 patients diagnosed by EBUS-TBNA, the concordance between the two maps was 0.768 for the right 92 LNs, while it was 0.374 for the left 46 nodes. If based on the location of azygous arches, postoperative stages might be changed in 2 surgery patients.ConclusionsThe locations of the lower vascular boundaries of IASCL-4 were varied. The bronchial landmarks of the proximal right and left main bronchus might be used as such borders.

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“…EBUS-TBNA has become a mature interventional diagnostic procedure in clinical practice. Previous studies have found no statistically significant difference in diagnostic sensitivity between EBUS-TBNA and mediastinoscopy for malignant lymph nodes evaluations, in cases where previous imaging results have indicated enlargement of mediastinal and/or hilar lymph nodes or adjacent lesions in the lungs [ 16 ]. However, compared to mediastinoscopy, EBUS-TBNA is less invasive, less expensive, and more tolerable for patients [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

et al. 2021

View full text Add to dashboard Cite

Background Endobronchial ultrasound (EBUS) elastography has been used in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely utilized for onsite evaluation of sample adequacy and for guiding sampling during EBUS-TBNA. The aim of this study was to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating mediastinal and hilar lymph node status. Methods Retrospective chart review was performed from December 2018 to September 2020. Patient demographics, EBUS elastography scores, and ROSE, pathologic, and clinical outcome data were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly nonblue; Type 2, partially blue and partially nonblue; and Type 3, predominantly blue. A receiver operating characteristic curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for evaluation of malignant lymph nodes among the EBUS elastography, ROSE, and EBUS combined with ROSE groups. Results A total of 245 patients (345 lymph nodes) were included. The sensitivity and specificity of the EBUS elastography group for the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under the curve was 0.942. Conclusions Combining EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph node status compared to each method alone.

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EBUS-TBNA versus surgical mediastinoscopy for mediastinal lymph node staging in potentially operable non-small cell lung cancer: a systematic review and meta-analysis

Cited by 23 publications

References 30 publications

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Demarcated by bronchial or vascular landmarks? a study on the lower borders of the lower paratracheal lymph nodes

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

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