Repeat mediastinoscopy in the staging of lung cancer

Pauwels, M; Schil, Paul Van; Backer, Wilfried De; Brande, F. Van Den; Eyskens, E

doi:10.1016/s1010-7940(98)00196-1

Cited by 38 publications

(27 citation statements)

References 13 publications

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“…(20) These data published in the literature make most authors suggest that the sensitivity and accuracy of EBUS is comparable with that of mediastinoscopy, although formal studies are needed to validate this conclusion. (18,19,21,22) Our experience demonstrates that, to obtain a high diagnostic yield with the use of EBUS, it is essential to promote the interaction among the various specialties involved in the use of the method.…”

Section: Discussionmentioning

confidence: 99%

Punção aspirativa guiada por ultrassom endobrônquico no diagnóstico e estadiamento de linfadenopatia mediastinal: experiência inicial no Brasil

et al. 2012

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Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of mediastinal lymph nodes. The objective of this study was to evaluate the preliminary results obtained with EBUS-TBNA in the diagnosis of lesions and mediastinal lymph node staging. Methods: We evaluated patients with tumors or mediastinal adenopathy, diagnosed with or suspected of having lung cancer. The procedures were performed with the patients under sedation or under general anesthesia. Material was collected by EBUS-TBNA, after which it was prepared on slides, fixed in either absolute alcohol (for cytology) or formalin (for cell-block analysis). Results: We included 50 patients (30 males). The mean age was 58.3 ± 13.5 years. We performed 201 biopsies of 81 lymph nodes or mediastinal masses (mean of 2.5 punctures/biopsy). The quantity of material was considered appropriate for cytology in 37 patients (74%), 21 (57%) of whom were thus diagnosed with malignancy. Of the remaining 16 patients, 1 was diagnosed with tuberculosis, 6 entered clinical follow-up, and 9 underwent further investigation (2 diagnosed with neoplasmfalse-negative results). The yield was higher when the procedure was performed for diagnostic purposes, as well as being higher in patients with lesions in multiple stations and in biopsies involving the subcarinal lymph node station. One patient had endobronchial bleeding, which was resolved with local measures. There were no deaths among the patients evaluated. Conclusions: This preliminary experience shows that EBUS-TBNA is a safe procedure. Our diagnostic yield, although lower than that reported in the literature, was consistent with the learning curve for the method.Keywords: Ultrasonography, interventional; Biopsy, fine-needle; Neoplasm staging; Lung neoplasms; Bronchoscopy. ResumoObjetivo: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA, punção aspirativa por agulha guiada por ultrassom endobrônquico) é um método novo em diagnóstico e estadiamento linfonodal mediastinal. O objetivo do estudo foi avaliar os resultados preliminares obtidos com EBUS-TBNA no diagnóstico de lesões e no estadiamento linfonodal mediastinal. Métodos: Foram avaliados pacientes com tumores ou adenopatias mediastinais e com diagnóstico ou suspeita de câncer de pulmão. Os procedimentos foram realizados com os pacientes sob sedação ou anestesia geral. O material coletado foi preparado em lâminas fixadas em álcool absoluto para citologia e em formol para bloco de células. Resultados: Foram incluídos 50 pacientes (30 do sexo masculino), com média de idade de 58,3 ± 13,5 anos. Foram realizadas 201 punções em 81 linfonodos ou massas mediastinais (média de 2,5 punções). O material obtido foi considerado adequado para análise citológica em 37 pacientes (74%), dos quais 21 (57%) foram diagnosticados com malignidade. Nos 16 pacientes remanescentes, 1 teve diagnóstico de tuberculose, 6 tiveram seguimento clínico, e 9 foram submetidos a investigação adicional...

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Section: Discussionmentioning

confidence: 99%

Punção aspirativa guiada por ultrassom endobrônquico no diagnóstico e estadiamento de linfadenopatia mediastinal: experiência inicial no Brasil

et al. 2012

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Section: İndüksi̇yon Tedavi̇si̇ Sonrasinda Medi̇asti̇nal Evrelemeunclassified

“…[45] Ancak, oluşan yapışıklıklar ve fibrozis nedeni ile zordur. [45] Özellikle ilk mediastinoskopide sağ alt paratrakeal gangliyondan önemli ölçüde biyopsi parçası alınmış ise, tekrar bu istasyondan biyopsi almak teknik olarak sorunludur. [45] Ancak, TEMLA, yeniden evrelemede şu ana kadar en iyi sonuçları, başka bir deyişle, gerçek patolojik lenf nodu tutulumunu ameliyat öncesinde gösteren en iyi 'tekrar evreleme' yöntemidir.…”

Section: İndüksi̇yon Tedavi̇si̇ Sonrasinda Medi̇asti̇nal Evrelemeunclassified

“…[45] Özellikle ilk mediastinoskopide sağ alt paratrakeal gangliyondan önemli ölçüde biyopsi parçası alınmış ise, tekrar bu istasyondan biyopsi almak teknik olarak sorunludur. [45] Ancak, TEMLA, yeniden evrelemede şu ana kadar en iyi sonuçları, başka bir deyişle, gerçek patolojik lenf nodu tutulumunu ameliyat öncesinde gösteren en iyi 'tekrar evreleme' yöntemidir. [46] Bu yöntem ile, tekrar evrelenen hastalarda negatif öngördürücü değer %99, hassasiyet %97 ve özgüllük %100 olarak bulunmuştur.…”

Section: İndüksi̇yon Tedavi̇si̇ Sonrasinda Medi̇asti̇nal Evrelemeunclassified

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The eighth staging system of non-small cell lung cancer and its practical implications

Turna¹

2017

Turk Gogus Kalp Dama

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ÖZEvreleme akciğer kanserli hastalara yaklaşımın önemli bir kısmını oluşturmaktadır. Tümör sınıflandırmasının esas amacı hastalığın anatomik yaygınlığını doğru olarak ortaya koymaktır. Tümörün anatomik yaygınlığı tedavi seçimi ve prognoz üzerinde önemli bir etkiye sahiptir. Küçük hücreli dışı akciğer kanserinde hastalara genel yaklaşım; mediastenin evrelenmesi ve toraks dışı evreleme için evreleme yöntemlerini, öykü ve fizik muayene, görüntüleme, minimal invaziv teknikler ve invaziv cerrahi teknikleri içermektedir. Mevcut akciğer kanseri evreleme sistemi tümör, lenf nodu ve metastaz (TNM) sınıflamasının Ocak 2017'de kullanılmaya başlanan sekizinci baskısıdır. Bu makalede, küçük hücreli dışı akciğer kanserinde evreleme yöntemleri ile birlikte mevcut TNM tanımlayıcıları ve evre grupları için tanımlar gözden geçirildi. Değişen T, N ve M tanımlayıcılarının hastalarda tedavi seçeneklerini daha iyi işaret edebildiği ve sağkalımı daha doğru bir şekilde öngörebildiği görülmektedir.Anah tar söz cük ler: Sekizinci evreleme sistemi; akciğer kanseri; M faktörü; N faktörü; T faktörü. ABSTRACTStaging is an essential part of the approach to patients with lung cancer. The primary goal of the tumor classification is to correctly describe the anatomic extent of the disease. The anatomic extent of the tumor has a major impact on the treatment selection and prognosis. The general approach to patients with non-small cell lung cancer include mediastinal staging and non-thoracic staging methods, history and physical examination, imaging, minimally invasive techniques, and invasive surgical techniques. The current lung cancer staging system is the eighth edition of the tumor, node, and metastasis (TNM) classification, which was took effect in January 2017. In this article, staging methods and the definitions for current T, N, M descriptors and the stage groups in non-small cell lung cancer are reviewed. New definitions of T, N, and M factors seem to better indicate the most optimal treatment option for an individual patient and to better predict the survival in patients.

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“…Horseness is a major complication that is avoidable during the procedure 20) by minimizing the use of electrocautery; a few minutes of gauze-packing pressure is sufficient for control of bleeding, except for large vessels20). Hemorrhage can be caused by tear lesions of the minor venous vessels and is controllable by local compression, positioning metallic clips or haemostatic sponges, sternotomy , or 3-day packing 3,4,17,18). Some patients will require thoracotomy and grafting of a superior vena cava vein by prosthesis18), which requires preoperative informed consent.…”

Section: Frozen Section Analysismentioning

confidence: 99%

Mediastinoscopy

Nonaka

Kataoka

Yamamoto

et al. 2003

The Showa University Journal of Medical Sciences

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Repeat mediastinoscopy in the staging of lung cancer

Abstract: Previous mediastinoscopy is no contraindication for a repeat one. Repeat mediastinoscopy offers valuable pathological information in restaging of lung cancer.

Cited by 38 publications

References 13 publications

Punção aspirativa guiada por ultrassom endobrônquico no diagnóstico e estadiamento de linfadenopatia mediastinal: experiência inicial no Brasil

Punção aspirativa guiada por ultrassom endobrônquico no diagnóstico e estadiamento de linfadenopatia mediastinal: experiência inicial no Brasil

The eighth staging system of non-small cell lung cancer and its practical implications

Mediastinoscopy

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