Endobronchial ultrasound-guided transbronchial needle aspiration versus mediastinoscopy for mediastinal staging of lung cancer: A systematic review of economic evaluation studies

Motta, João Pedro Steinhauser; Steffen, Ricardo Ewbank; Lobato, Caroliny Samary Silva; Mendonça, Vanessa Souza; Silva, José Roberto Lapa e

doi:10.1371/journal.pone.0235479

Cited by 11 publications

(9 citation statements)

References 33 publications

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“…5,6 A small prospective randomized trial did not find any additive value of performing EUS in patients who first underwent EBUS. 29 Randomized trials 30,138 and aggregate data from these MAs demonstrate that endoscopic-based staging is at least equivalent to mediastinoscopy and is more cost-effective, 139,140 at least when used as the first staging modality. A 2017 decision analysis suggests that the cost-effectiveness of EBUS-based mediastinal staging varies by the pretest probability of N2 disease with mediastinal staging not cost-effective in clinical N0 patients if the probability of N2 involvement is very low (< 2.5%).…”

Section: Recommendationsmentioning

confidence: 99%

Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline

Daly

Singh

Ismaila

et al. 2022

JCO

162

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PURPOSE To provide evidence-based recommendations to practicing clinicians on management of patients with stage III non–small-cell lung cancer (NSCLC). METHODS An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary oncology, community oncology, research methodology, and advocacy experts was convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2021. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 127 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Evidence-based recommendations were developed to address evaluation and staging workup of patients with suspected stage III NSCLC, surgical management, neoadjuvant and adjuvant approaches, and management of patients with unresectable stage III NSCLC. Additional information is available at www.asco.org/thoracic-cancer-guidelines .

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Section: Recommendationsmentioning

confidence: 99%

Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline

Daly

Singh

Ismaila

et al. 2022

JCO

162

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“…Several studies have compared the cost-effectiveness and safety of EBUS-TBNA for diagnosis versus mediastinoscopy 13 , 14 . Certainly according to current guidelines for lung cancer PET-CT and EBUS-TBNA have an algorithm before mediastiscopy is performed 15 .…”

Section: Discussionmentioning

confidence: 99%

Priority of PET-CT vs CT Thorax for EBUS-TBNA 22G vs 19G: Mesothorax Lymphadenopathy

Huang¹,

Hu²,

Wu³

et al. 2021

J. Cancer

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Introduction: Lung lesions and undiagnosed mesothorax lymphadenopathy is an issue that several doctors face in the everyday clinical practice. PET-CT and CT of the thorax are usually the first examinations to identify characteristics of the lesions before biopsy. Patients and Methods: We performed a retrospective study with 450 patients that had EBUS-TBNA with 22G, Upgraded 22G and 19G needles with and without PET-CT in order to identify the cost effeteness of performing EBUS-TBNA before or after PET-CT. All centers used the same PET-CT equipment and EBUS-TBNA system. Three types of needle were used for the endoscopy in order to identify similarities and differences for the cost-effectiveness. The costs in every center for every examination and materials were the same. Results: There were more block slices for 19G>22Gupgraded>21G>22G and there was cost-effectiveness when in general PET-CT was performed prior to biopsy of any lesion. 19G needle was more effective for lymphomas, while 22Gupgraded and 21G needles were more cost-effective when used for smaller lesions for primary lung cancer of metastatic disease. Conclusions: We have been using PET-CT and EBUS-TBNA in the everyday clinical practice according to the current guidelines for initial disease staging and re-staging. However; we can also use both in a cost effective method based on the initial radiologic findings.

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“…COST Motta et al [83] reported lower cost for EBUS compared with mediastinoscopy [84]. Between 2007 and 2015, the mean cost of EBUS-TBNA in the USA was $2211 less than mediastinoscopy ($6816 versus $9023; P < 0.001).…”

Section: Safetymentioning

confidence: 99%

Lung cancer staging, the established role of bronchoscopy

Marshall

Kalanjeri

Almeida

2021

Current Opinion in Pulmonary Medicine

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Purpose of reviewLung cancer is the leading cause of cancer-related deaths worldwide. In the absence of distant metastases, accurate mediastinal nodal staging determines treatment approaches to achieve most favourable outcomes for patients. Mediastinal staging differentiates N0/N1 disease from N2/N3 in surgical candidates. Likewise, presence of nodal involvement in nonsurgical candidates who are being considered for stereotactic body radiation therapy is also critical. This review article seeks to discuss the current options available for mediastinal staging in nonsmall cell lung cancer (NSCLC), particularly the role of bronchoscopy. Recent findingsAlthough several techniques are available to stage the mediastinum, bronchoscopy with EBUS-TBNA with or without EUS-FNA appears to be superior in most clinical situations based on its ability to concomitantly diagnose and stage at once, safety, accessibility to the widest array of lymph node stations, cost and low risk of complications. However, training and experience are required to achieve consistent diagnostic accuracy with EBUS-TBNA. SummaryEBUS-TBNA with or without EUS-FNA is considered the modality of choice in the diagnosis and staging of NSCLC in both surgical and nonsurgical candidates.

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Endobronchial ultrasound-guided transbronchial needle aspiration versus mediastinoscopy for mediastinal staging of lung cancer: A systematic review of economic evaluation studies

Cited by 11 publications

References 33 publications

Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline

Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline

Priority of PET-CT vs CT Thorax for EBUS-TBNA 22G vs 19G: Mesothorax Lymphadenopathy

Lung cancer staging, the established role of bronchoscopy

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