OC.09.6 Role of Eus Fna in Diagnosis and Staging of Lung Cancer

Assisi, D.; M, Filippetti; Federici, T.; Visca, P.; Anti, M.

doi:10.1016/s1590-8658(13)60210-8

Cited by 3 publications

(4 citation statements)

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“…Two of these included studies were conference abstracts [21,26] . Through personal communication, we were also able to include 1 additional study for which the report had been accepted for publication at the time of our searches but which had not yet been published [29] .…”

Section: Study Selectionmentioning

confidence: 99%

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Esophageal Endosonography for the Diagnosis of Intrapulmonary Tumors: A Systematic Review and Meta-Analysis

Korevaar

Colella²,

Spijker³

et al. 2016

Respiration

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Background: Biopsy-based diagnosis in patients with paraesophageal intrapulmonary tumors suspected of lung cancer is crucial for adequate treatment planning. Objective: To evaluate the performance of transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the diagnosis of intrapulmonary tumors located near or adjacent to the esophagus. Methods: We performed a systematic review (PROSPERO, CRD42016033737) and searched MEDLINE, Embase, BIOSIS Previews, and Web of Science on September 22, 2016, without date or language restrictions. We included studies that evaluated the yield and/or sensitivity of EUS-FNA for diagnosing intrapulmonary tumors. Yield was defined as the number of patients in whom EUS-FNA made a biopsy-proven diagnosis (malignant or nonmalignant) relative to the total number of patients on whom EUS-FNA was performed. Sensitivity was defined as the number of patients in whom EUS-FNA made a biopsy-proven diagnosis of malignancy relative to the total number of patients in whom the tumor was found to be malignant. We performed a random-effects meta-analysis. Results: Of 3,320 search results, 11 studies were included. Ten had a high risk of bias. The total number of patients was 313; the proportion of patients with malignancy ranged from 87 to 100% across these studies. The average yield was 0.90 (95% CI 0.82-0.95) and the average sensitivity was 0.92 (0.83-0.96). In the subgroup of prospective studies (n = 3), the average yield was 0.80 (0.56-0.93) and the average sensitivity was 0.83 (0.58-0.95). EUS-FNA-induced complications were reported for 5/256 patients (2.0%) for whom this information was available. Conclusions: Although the number of high-quality studies is limited, these findings suggest that EUS-FNA is safe and has a high yield for diagnosing intrapulmonary tumors.

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Section: Study Selectionmentioning

confidence: 99%

“…Songür [25], 2011 "pulmonary masses invading the mediastinum" Assisi [26], 2013 "pulmonary localization of disease"; "localized in dorsal superior segments"…”

Section: Study Qualitymentioning

confidence: 99%

Esophageal Endosonography for the Diagnosis of Intrapulmonary Tumors: A Systematic Review and Meta-Analysis

Korevaar

Colella²,

Spijker³

et al. 2016

Respiration

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“…A study involving pneumologists showed a very good diagnostic yield (26 of 27 patients) for EUS performed with an echobronhoscope [12]. A relatively recent systematic review and metaanalysis [21] which included 11 studies, with a total of 313 patients [9,13,[22][23][24], showed an average diagnostic yield of 0.90 and an average sensitivity of 0.92 for diagnosing intrapulmonary lung tumors by EUS using the gastrointestinal echoendoscope. The complications rate found was less than 2% [21].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of paraesophageal lung tumors – diagnostic yield and added value

Chira

Ichim

et al. 2019

Med Ultrason

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Aims: There are few data on the use of endoscopic ultrasound (EUS) for the biopsy of suspected malignant lesions of the lung. The main objective of this study was to evaluate the performance of transesophageal EUS fine needle aspiration (EUSFNA) for the diagnosis of paraesophageal lung tumors and also for the confirmation of metastatic sites of lung cancer during the same procedure.Material and methods: We performed a retrospective study in a tertiary care unit including 19 patientswith paraesophageal lung tumors referred to our department for a lung biopsy. Transesophageal EUS-FNA was performed using a linear echoendoscope and 22G needles.Results: In all 19 patients with suspected lung tumors the confirmation of the malignant disease was achieved. Pathological examination revealed 16 cases of non-small cell lung cancers, 2 small cell lung cancers and one case of lung metastases. Diagnostic yield of lung EUS-FNA was 1, with no post-procedural complications. In 7 cases, we performed also biopsies of suspected metastasis and all biopsies revealed the same histopathological type as the primary tumor.Conclusions: Our study supports the use of this minimally invasive technique for paraesophageally locatedlung tumors and demonstrates that EUS-FNA is safe and has an excellent diagnostic yield.

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“…Unfortunately, it is unknown what the term "immediately adjacent" covers. Studies on EUS-FNA from intrapulmonary tumors [2][3][4][5][6][7][8][9][10][11] rarely report the distance between esophagus and the lung tumor. When reported, the distances vary greatly (from below 10 up to 46 mm) [3,4,10,11].…”

Section: Introductionmentioning

confidence: 99%

Characterization of Lung Tumors that the Pulmonologist can Biopsy from the Esophagus with Endosonography (EUS-B-FNA)

et al. 2021

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Background: According to guidelines, it is possible to biopsy lung tumors “immediately adjacent to the esophagus” with EUS-B-FNA. However, it is unknown what “immediately adjacent” exactly means. Objective: to investigate the possibility of achieving EUS-B-FNA biopsies from a lung tumor depending on the distance from the esophagus and to establish the maximal allowable distance between the tumor and the esophagus. Methods: In a prospective observational study, we included patients with a lung tumor located maximum 6 cm from the esophagus and indication of EUS-B-FNA from the tumor. The tumors were of different sizes. In a plot presenting the tumor size-distance relationship in cases with (biopsy) versus without (non-biopsy) successful EUS-B-FNA, a separation line representing the threshold between the groups were identified and a biopsy-index equation established. The maximal tumor-size corrected distance (TSCD) was calculated using the residuals to the separation line. Results: In total, 70 patients were included. EUS-B-FNA from the lung tumor was possible in 46 patients. All tumors with a distance from the esophagus below 19 mm could be biopsied. The maximal allowable esophagus-tumor distance depended on tumor size. From the separation line, a biopsy-index equation was established with the sensitivity of 93.5%, a specificity of 100%, and total accuracy of 95.7%. The TSCD was 31 mm (sensitivity: 95.7%, specificity 75.0%, and accuracy: 88.6%). Conclusion: We established a biopsy-index equation to predict the achievability of a lung tumor using EUS-B-FNA depending on distance to esophagus and tumor size. A general maximal TSCD was 31 mm.

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OC.09.6 Role of Eus Fna in Diagnosis and Staging of Lung Cancer

Cited by 3 publications

References 0 publications

Esophageal Endosonography for the Diagnosis of Intrapulmonary Tumors: A Systematic Review and Meta-Analysis

Esophageal Endosonography for the Diagnosis of Intrapulmonary Tumors: A Systematic Review and Meta-Analysis

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of paraesophageal lung tumors – diagnostic yield and added value

Characterization of Lung Tumors that the Pulmonologist can Biopsy from the Esophagus with Endosonography (EUS-B-FNA)

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