Endobronchial ultrasound-guided transbronchial needle aspiration and cervical mediastinoscopy for mediastinal staging of non-small cell lung cancer: a retrospective comparison study

Abstract

and N staging analysis were conducted in this study. Results: Fifty-five patients received EBUS-TBNA and one hundred and ninety patients received CMS were included into the analysis set. In per case analysis, no significant differences were seen between EBUS-TBNA and CMS in N staging accuracy (83.6% vs. 78.9%, P=0.444). EBUS-TBNA had significantly higher sensitivity than CMS (82.4% vs. 47.6%, P=0.039) in malignant lymph nodes diagnosis. In lymph nodes diagnosis comparison (station #2, #4 and #7), both EBUS-TBNA and CMS showed high diagnostic sensitivity, specificity and accuracy (82.4% vs. 94.7%, P=0.130; 97.4% vs. 100%, P=0.173; 98.8% vs. 92.9%, P=0.025; respectively), CMS had slightly better diagnostic accuracy rate than EBUS-TBNA. Malignant lymph nodes had longer short axis than benign nodes (mean 14.2 vs. 6.5 mm, P<0.001). In lymph nodes with a short axis ≥15 mm, the malignant rate was 48.8%. More complications and injuries were found in patients receiving CMS. Conclusions: For clinically suspected lung cancers with enlarged mediastinal lymph nodes, both EBUS-TBNA and CMS are favorable invasive mediastinal staging options. EBUS-TBNA may be preferred for its higher malignant diagnostic sensitivity and fewer complications.

Unforeseen N2 Disease after Negative Endosonography Findings with or without Confirmatory Mediastinoscopy in Resectable Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

“…2). Of these studies, 12 evaluated EBUS, [11][12][13][14][15][16][17][18][19][20][21][22] seven evaluated EUS, 13,[23][24][25][26][27][28] and 12 evaluated combined EBUS and EUS as a staging method. 13,[29][30][31][32][33][34][35][36][37] One study was a randomized controlled trial (RCT) comparing staging by EBUS followed by EUS versus EUS followed by EBUS, and one study was an observational study comparing EBUS plus EUS versus EBUS plus EUS with use of the EBUS scope.…”

Mediastinal Nodal Staging Performance of Combined Endobronchial and Esophageal Endosonography in Lung Cancer Cases: A Systematic Review and Meta-Analysis

“…Establishing EBUS or EUS as a diagnostic and therapeutic method is therefore still a challengd ( 56 ). Given the cost of interventional EBUS or EUS is high and EBUS or EUS is deficient in majority of regions, tsherefore, when these two methods are implemented, several concerns arise, such as they are likely to be more operator-dependent and have a steeper learning curve compared to the initial mediastinal staging for lung cancer cases ( 57 , 58 ).…”

Application of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and treatment of mediastinal lymph node tuberculous abscess: a case report and literature review

“…EBUS-TBNA is a minimally invasive and safe procedure for the assessment of mediastinal lymphadenopathy [ 5 – 10 ]. We searched the Web of Science and PubMed databases for references using “mediastinal lymph node”, “tuberculosis” and “endobronchial ultrasound-guided transbronchial needle aspiration”.…”

“…Although EBUS-TBNA has been successfully used for the diagnosis of mediastinal lymphadenopathy such as MLNTB [ 5 – 10 ], there have no studies reporting the application of EBUS-TBNA in the diagnosis and/or treatment of MLNTAs yet. This may be the first report introducing the employment of EBUS-TBNA to puncture and aspirate pus for diagnosis of MLNTAs and administer drugs to treat MLNTAs.…”

“…and inject drugs in lesions [ 4 ]. EBUS-TBNA has recently been developed as a minimally invasive and safe procedure for the diagnosis of mediastinal lymphadenopathy such as MLNTB [ 5 – 8 ], mediastinal lymphoma [ 9 ], and mediastinal staging of lung cancer [ 10 ], with satisfactory safety and accuracy. However, the application of EBUS-TBNA in the diagnosis and treatment of MLNTA has not been reported yet.…”