Prevalence of nodal metastases in lymph node stations 8 &amp; 9 in a large UK lung cancer surgical centre without routine pre-operative EUS nodal staging

Evison, Matthew; Edwards, Timothy L.; Balata, Haval; Tempowski, Alex; Teng, Benjamin; Bishop, Paul; Fontaine, Eustace; Krysiak, Piotr; Rammohan, Kandadai; Booton, Richard

doi:10.1016/j.lungcan.2017.11.023

Cited by 7 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, of the five additional pathologic lymph nodes detected by EUS, four of the involved stations were also accessible by EBUS (4L and 7), and station 8 involvement was seen in only two patients (<1%). A similarly low incidence of station 8 and 9 involvement in NSCLC has been demonstrated in other studies [42 ▪ ,44], suggesting that the overall benefit of EUS to EBUS, when performed in a systematic manner, may be limited. The addition of EUS or EUS-B may be best utilized in patients with positive stations 8 or 9 on noninvasive staging or when there is sampling difficulty with EBUS either due to needle angulation, puncturing through cartilage, inadequate contact with the airway wall or patient intolerance due to intractable cough.…”

Section: Complete Lung Cancer Staging – When Is It Indicated and What...supporting

confidence: 66%

What is new in mediastinal staging?

Schwalk,

Niroula,

Schimmel

2023

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

Purpose of review Appropriate staging is of utmost importance in nonsmall cell lung cancer (NSCLC), as the pathologic stage dictates both overall prognosis and appropriate therapeutic pathways. This article seeks to review the current recommendations for mediastinal staging of NSCLC and available modalities to achieve this. Landmark publications pertaining to recent advancements in NSCLC treatments are also highlighted and the role of specific bronchoscopic modalities for tissue acquisition are reviewed. Recent findings Recent advancements in the treatment of NSCLC have made accurate mediastinal staging more important than ever. Guidelines and recommendations outlining patients that warrant invasive mediastinal staging are available and a systematic approach should be utilized when sampling is performed. Ensuring the adequacy of tissue for the growing number of molecular biomarkers that must be tested has been the focus of many recent studies. Summary Appropriate mediastinal staging is crucial for the management of patients with NSCLC as is obtaining adequate tissue for diagnostic and therapeutic purposes. EBUS-TBNA is sufficient for the diagnosis of nonsmall cell and small cell lung carcinomas, but EBUS-guided intranodal forceps and cryobiopsy may provide more optimal specimen for patients with benign disease, such as sarcoidosis, or in cases of lymphoma. Further studies are necessary to better delineate the role of these techniques in the diagnosis and staging of mediastinal diseases before they become the primary diagnostic modalities.

show abstract

Section: Complete Lung Cancer Staging – When Is It Indicated and What...supporting

confidence: 66%

What is new in mediastinal staging?

Schwalk,

Niroula,

Schimmel

2023

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

show abstract

“…metastáticos apenas nessas estações, sendo que não foi encontrada diferença estatisticamente significativa na sobrevida entre 12 pacientes e os outros 724. (15) Na presente revisão sistemática, buscamos evidências de que a EBUS-TBNA é o único procedimento capaz de realizar eficazmente o estadiamento linfonodal mediastinal em pacientes com CPCNP.…”

Section: Discussionunclassified

“…No entanto, diferentemente da EBUS-TBNA, a EUS-FNA permite acesso aos linfonodos paraesofágicos, infradiafragmáticos e retroperitoneais inferiores, sendo que os dois últimos têm menor impacto clínico na estratégia terapêutica. (15) Dong et al, (16) em uma meta-análise, avaliaram a eficácia da EBUS-TBNA no estadiamento linfonodal mediastinal em CPCNP. No entanto, nenhum dos estudos selecionados comparou EBUS-TBNA com mediastinoscopia.…”

Section: Introductionunclassified

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

Figueiredo¹,

Cardoso²,

Jacomelli³

et al. 2020

J Bras Pneumol.

View full text Add to dashboard Cite

Objetivo: O câncer de pulmão (CP) é uma das principais causas de morte no mundo. Um estadiamento mediastinal preciso é obrigatório para avaliação do prognóstico e seleção de pacientes para tratamento cirúrgico. EBUS-TBNA é um procedimento minimamente invasivo que permite a amostragem de linfonodos mediastinais. Alguns estudos sugerem que a EBUS-TBNA é preferível que a mediastinoscopia cirúrgica no estadiamento mediastinal do CP. O objetivo desta revisão sistemática e meta-análise foi comparar a eficácia da EBUS-TBNA e da mediastinoscopia no estadiamento linfonodal mediastinal do câncer de pulmão de células não pequenas (CPCNP) potencialmente operável. Métodos: Foram pesquisados diversos bancos de dados. Estudos comparando a precisão da EBUS-TBNA e da mediastinoscopia no estadiamento linfonodal mediastinal em pacientes com CPCNP foram incluídos. Na meta-análise, foram calculadas sensibilidade e especificidade, bem como razões de verossimilhança positiva e negativa. A diferença de risco de complicações relatadas para cada procedimento também foi analisada. Resultados: A pesquisa identificou 4.201 artigos, dos quais 5 foram selecionados para a meta-análise (total combinado de 532 pacientes). Não houve diferenças estatisticamente significativas entre EBUS-TBNA e mediastinoscopia: sensibilidade (81% vs. 75%), especificidade (100% para ambas), razão de verossimilhança positiva (101,03 vs. 95,70) e razão de verossimilhança negativa (0,21 vs. 0,23). A área sob a curva summary ROC para EBUS-TBNA e para mediastinoscopia foi de 0,9881 e 0,9895, respectivamente. Embora o número de complicações tenha sido maior para mediastinoscopia, não foi encontrada diferença significativa (diferença de risco: −0,03; IC95%: −0,07 to 0,01; I 2 = 76%). Conclusões: EBUS-TBNA e mediastinoscopia apresentaram resultados semelhantes no estadiamento mediastinal do CPCNP. EBUS-TBNA pode ser o procedimento de primeira escolha no estadiamento linfonodal em pacientes com CPCNP.Descritores: Neoplasias pulmonares/diagnóstico; Estadiamento de neoplasias; Neoplasias do mediastino/diagnóstico; Aspiração por agulha fina guiada por ultrassom endoscópico; Mediastinoscopia.

show abstract

“…Over 80% of the patients in this study had T2 or T3 lesions but a detailed clinical N stage was not provided. In another study in which 736 patients with NSCLC undergoing surgery had their stations 8 and/or 9 dissected, only 34 (4.6%) were found to have metastasis to either or both nodes [40]. Moreover, 18 of these had multistation N2 disease of EBUS accessible nodes.…”

Section: Eus-fna/eus-bmentioning

confidence: 97%

Lung cancer staging, the established role of bronchoscopy

Marshall

Kalanjeri

Almeida

2021

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

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.

show abstract

Prevalence of nodal metastases in lymph node stations 8 & 9 in a large UK lung cancer surgical centre without routine pre-operative EUS nodal staging

Cited by 7 publications

References 11 publications

What is new in mediastinal staging?

What is new in mediastinal staging?

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

Lung cancer staging, the established role of bronchoscopy

Contact Info

Product

Resources

About