Endosonography for lung cancer staging: predictors for false-negative outcomes

Yazdi, Mehrdad Talebian; Egberts, J.; Schinkelshoek, Mink S.; Wolterbeek, Ron; Nabers, J; Venmans, Ben J.W.; Tournoy, Kurt G.; Annema, Jouke T.

doi:10.1016/j.lungcan.2015.09.020

Cited by 14 publications

(3 citation statements)

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“…In the present study, the rate of false negative results on N2/3 LNs by EBUS/EUS-NA was 111/705 (15.7%). Among the patients with false negative results, 24/111 (21.6%) had false negative results to inaccessible LNs, and these rates were similar to those reported in previous studies [9, 10]. Previous studies have identified several factors associated with false negative results of EBUS/EUS-NA [9, 10, 17], including primary tumor location (central or left lung), abnormal findings of mediastinal LNs on CT and/or PET, inadequacy of the sampling, internal necrosis in the LNs, and rare cancer types.…”

Section: Discussionsupporting

confidence: 88%

“…Among the patients with false negative results, 24/111 (21.6%) had false negative results to inaccessible LNs, and these rates were similar to those reported in previous studies [9, 10]. Previous studies have identified several factors associated with false negative results of EBUS/EUS-NA [9, 10, 17], including primary tumor location (central or left lung), abnormal findings of mediastinal LNs on CT and/or PET, inadequacy of the sampling, internal necrosis in the LNs, and rare cancer types. Although we did not perform multivariate analysis to identify the independent patient and tumor characteristics associated with false negative results, young age, female gender, inaccessible stations by EBUS, and larger size of LNs had a trend for higher false negative rates (Tables 1 and 2).…”

Section: Discussionsupporting

confidence: 88%

“…There are many published studies about patient-related and tumor-related predictors for false negative results of EBUS/EUS-NA [9, 10], but few reports about operator-related factors. Although many studies have evaluated how fast individual trainees adjust to the procedure as assessed by various evaluation tools [7, 11, 12], there is a lack of studies analyzing the false negative rates of EBUS/EUS-NA depending on operator and using surgical staging as the reference value.…”

Section: Introductionmentioning

confidence: 99%

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Are there differences among operators in false-negative rates of endosonography with needle aspiration for mediastinal nodal staging of non-small cell lung cancer?

et al. 2019

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BackgroundEndosonography with needle aspiration (EBUS/EUS-NA) is recommended as the first choice for mediastinal nodal assessment in non-small cell lung cancer (NSCLC). It is important to maintain adequate negative predictive value of the procedure to avoid unnecessary additional surgical staging, but there are few studies on the influence of operator-related factors including competency on false negative results. This study aims to compare the false negative rate of individual operators and whether it changes according to accumulation of experience.MethodsThis is a retrospective study of NSCLC patients who were N0/N1 by EBUS/EUS-NA and confirmed by pathologic staging upon mediastinal lymph node dissection (n = 705). Patients were divided into a false negative group (finally confirmed as pN2/N3) and a true negative group (pN0/N1). False negative rates of six operators and whether these changed according to accumulated experience were analyzed.ResultsThere were 111 (15.7%) false negative cases. False negative rates among six operators ranged from 8.3 to 21.4%; however, there were no statistical differences before and after adjustment for patient characteristics and procedure-related factors (P = 0.346 and P = 0.494, respectively). In addition, false negative rates did not change as each operator accumulated experience (P for trend = 0.632).ConclusionsOur data suggest that there would be no difference in false negative rates regardless of which operator performs the procedure assuming that the operators have completed a certain period of observation and have performed procedures under the guidance of an expert.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0774-6) contains supplementary material, which is available to authorized users.

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