Prospective comparison of radiologic, thoracoscopic, and pathologic staging in patients with early non-small cell lung cancer

Roberts, John R.; Blum, Matthew G.; Arildsen, Ron; Drinkwater, Davis C.; Christian, Karla R; Powers, Thomas A.; Merrill, Walter H.

doi:10.1016/s0003-4975(99)00983-2

Cited by 64 publications

(31 citation statements)

References 23 publications

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“…(22) Thoracoscopy has been used in order to increase CS accuracy. One group of authors, (23) analyzing patients with negative cervical mediastinoscopy results whose T and N were evaluated with the aid of thoracoscopy, through pleural lavage cytology, in addition to biopsy of paraesophageal lymph node groups and of the pulmonary ligament in tumors located in lower lobes (when possible, biopsy of the interlobar or intersegmental groups was performed, and the subcarinal and paratracheal lymph nodes were only sampled if they had a pathological aspect), found that thoracoscopy presented no complications, being considered more accurate than chest CT since it staged 88% of the cases correctly, compared with 42% for CT. Its greatest benefit was staging the factor T correctly in 96% of the cases.…”

Section: Discussionmentioning

confidence: 99%

Concordância entre os estadiamentos clínico e patológico em pacientes com câncer de pulmão não-pequenas células, estádios I e II, submetidos a tratamento cirúrgico

et al. 2007

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Objective: To compare clinical and pathological staging in patients with non-small cell lung cancer submitted to surgical treatment, as well as to identify the causes of discordance. Methods: Data related to patients treated at the Department of Thoracic Surgery of the Pontifical Catholic University of Rio Grande do Sul São Lucas Hospital were analyzed retrospectively. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for clinical stages IA, IB, and IIB. The kappa index was used to determine the concordance between clinical and pathological staging. Results: Of the 92 patients studied, 33.7% were classified as clinical stage IA, 50% as IB, and 16.3% as IIB. The concordance between clinical and pathological staging was 67.5% for stage IA, 54.3% for IB, and 66.6% for IIB. The accuracy of the clinical staging was greater for stage IA, and a kappa of 0.74, in this case, confirmed a substantial association with pathological staging. The difficulty in evaluating nodal metastatic disease is responsible for the low concordance in patients with clinical stage IB. Conclusions: The concordance between clinical and pathological staging is low, and patients are frequently understaged (in the present study, only one case was overstaged). Strategies are necessary to improve clinical staging and, consequently, the treatment and prognosis of patients with non-small cell lung cancer.

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Section: Discussionmentioning

confidence: 99%

Concordância entre os estadiamentos clínico e patológico em pacientes com câncer de pulmão não-pequenas células, estádios I e II, submetidos a tratamento cirúrgico

et al. 2007

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“…The efficacy of VATS for station #5 and #6 nodal biopsy has been documented, and diagnostic accuracy rates of 92%-100% have been reported [63][64][65][66].…”

Section: Staging Of Mediastinal Lymph Nodesmentioning

confidence: 99%

“…Regarding this topic, Roberts et al [66] mentioned that VATS helps to establish the diagnosis of N2 involvement of the #8 and #9 nodes, especially in patients with lower lobe tumors and negative cervical mediastinoscopy.…”

Section: Staging Of Mediastinal Lymph Nodesmentioning

confidence: 99%

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Solli

Spaggiari

2007

The Oncologist

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After completing this course, the reader will be able to:1. Discuss the role of thoracoscopy in the evaluation of pulmonary nodules and pleural effusion.2. Describe the role of thoracoscopy in the staging of lung cancer.3. Discuss the role of thoracoscopy in surgical resection of early-stage lung cancer.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThe term video-assisted thoracic surgery (VATS) is used to describe a modern minimally invasive surgical technique that nowadays represents a valid alternative to open procedures (i.e., thoracotomy) for many chest diseases. The VATS approach is presently used in many intrathoracic disorders, but while well established in benign chest disease, its role continues to evolve regarding the management of lung cancer. It is currently considered for the evaluation and treatment of suspected (or known) pleural effusion and in the diagnosis of indeterminate pulmonary nodules, and it has a complementary role to standard cervical mediastinoscopy in the invasive staging of mediastinal lymph nodes. It has also become an accepted approach for resection of peripheral early-stage lung cancer (stage I) in many centers worldwide and considerable experience has been accumulated in respect to this field, but absolute indications have yet to be firmly defined. This paper reviews indications and current data regarding minimally invasive approaches for the staging and treatment of lung cancer.

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“…Some authors suggest the use of VATS in the pre-operative routine [25,26] although, in literature, such an approach is debated. With a minimally invasive thoracoscopic procedure it is possible to significantly reduce the incidence of diagnostic thoracotomies; on the other hand, patients considered inoperable at imaging in the past can be enrolled for a major resection [27,28]. Another important benefit of VATS is the possibility to correctly evaluate tumour …”

Section: Video-assisted Thoracoscopymentioning

confidence: 99%

Surgical procedures in mediastinal lung cancer staging

Boaron¹,

Kawamukai²,

Parri³

et al. 2006

Annals of Oncology

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Prospective comparison of radiologic, thoracoscopic, and pathologic staging in patients with early non-small cell lung cancer

Cited by 64 publications

References 23 publications

Concordância entre os estadiamentos clínico e patológico em pacientes com câncer de pulmão não-pequenas células, estádios I e II, submetidos a tratamento cirúrgico

Concordância entre os estadiamentos clínico e patológico em pacientes com câncer de pulmão não-pequenas células, estádios I e II, submetidos a tratamento cirúrgico

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Surgical procedures in mediastinal lung cancer staging

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