<scp>EBUS</scp> may arise as an initial time saving procedure in patients who are suspected to have small cell lung cancer

Öztürk, Ayperi; Demirci, Nilgün Yılmaz; Aktaş, Zafer; Demırağ, Funda; Alagöz, Ali; Alıcı, İbrahim Onur; Yılmaz, Aydın

doi:10.1111/crj.12556

Cited by 7 publications

(10 citation statements)

References 18 publications

(32 reference statements)

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“…Only 16.6% (28/169) of patients required more than one procedure compared to 28.4% (215/756) of patients who did not initially undergo EBUS. Other studies have shown similar results . These studies also showed a positive correlation between the time to diagnosis and treatment decisions and survival .…”

Section: Discussionsupporting

confidence: 74%

Predicting delays in lung cancer diagnosis and staging

et al. 2019

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BackgroundDespite growing interest in increasing the efficiency and speed of the diagnosis, staging, and treatment of lung cancer (LC), the interval from signs and symptoms to diagnosis and treatment remains longer than recommended. The aim of this study was to analyze the factors that cause delays in the LC diagnosis/staging process and, consequently, delays in making therapeutic decisions.MethodsWe analyzed audit data from a prospective dataset of 1330 patients assessed at The Lung Cancer Rapid Diagnostic Unit from 26 June 2013 to 26 March 2016. The number and type of procedures and medical tests and the times of all procedures were recorded. Clinical and epidemiological variables and whether the diagnosis was performed on an inpatient or outpatient basis were also recorded.ResultsMalignancy was confirmed in 737 (55.4%) of the 1330 patients, with LC in 627 of these (85.2%). The mean interval to final diagnosis was 19.8 ± 13.9 days. Variables significantly related to a longer diagnostic time were the number of days until computed tomography (CT) was performed (odds ratio [OR], 95% confidence interval [CI] 1.347, 1.103–1.645; P = 0.003), until a histology sample was obtained (OR 1.243, 95% CI1.062–1.454; P = 0.007), and the total number of tests performed during the diagnostic and staging process (OR 1.823, 95% CI 1.046–3.177; P = 0.03).ConclusionsA greater number of tests and more days to CT and histology led to longer delay times. Optimization of these factors should reduce delays in the LC diagnosis process.

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Section: Discussionsupporting

confidence: 74%

Predicting delays in lung cancer diagnosis and staging

et al. 2019

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“…They found that both time intervals were significantly shorter in patients in which the first diagnostic procedure was EBUS‐TBNA, compared with patients in which other procedures were undertaken first. The authors noted that, for patients with extensive disease, the diagnostic work‐up time nearly equalled their expected survival time, if they did not receive treatment …”

Section: Resultsmentioning

confidence: 99%

“…The effects of this multifunctionality are evident from the results of the Lung‐BOOST trial, where EBUS‐TBNA was able to reduce the mean time to treatment decision by half, mainly by reducing the number of outpatient appointments and investigations . It has been suggested that, if the presenting hospital does not have the capability to perform EBUS‐TBNA, then patients that are candidates for EBUS‐TBNA (probable or proven mediastinal involvement, absence of metastatic disease) should be referred to centres that do . Importantly, if after the initial CT there is evidence of a peripheral lung lesion and mediastinal involvement, and EBUS‐TBNA is not available, then the next step should not be a CT‐guided biopsy of the peripheral lesion, as it will only provide diagnostic but not staging information.…”

Section: Resultsmentioning

confidence: 99%

EBUS: Faster, cheaper and most effective in lung cancer staging

et al. 2018

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The use of endobronchial ultrasound trans-bronchial needle aspiration (EBUS-TBNA) as the initial diagnostic and staging procedure in patients with suspected, non-metastatic lung cancer has gained substantial support, and is now recommended by numerous guidelines. Whereas considerable attention has been pointed to the reductions in costs achieved by EBUS-TBNA, that has not been the case for some of its more significant benefits, namely the reduction of the diagnostic work-up time and its ability to accurately assess and restage lymph nodes, which were previously stated incorrectly by CT or PET scan. Both these benefits translate into improved outcomes for patients, as delays are reduced, futile surgeries are prevented and curable operations can be performed on patients previously excluded by CT or PET scan. Indeed, the use of EBUS as the initial diagnostic and staging procedure has been proven to significantly increase survival, compared with conventional diagnostic and staging procedures, in a pragmatic, randomised controlled trial (Navani N. et al, 2015). The instalment of EBUS will have the greatest effect on overwhelmed, suboptimally functioning national healthcare systems, by decreasing the number of required diagnostic and staging procedures, therefore reducing both treatment delays and costs. The improved selection of surgical candidates by EBUS will result in improved patient outcomes. The latest findings regarding the benefits of EBUS are outlined in this review, which, to the best of our knowledge, is the first to emphasise the impact of the procedure, both on timing and costs of lung cancer staging, as well as on survival.

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“…Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is a minimally invasive modality for nodal staging in lung cancer patients . In addition, EBUS‐TBNA is widely used for the diagnosis of benign conditions, for example, sarcoidosis related mediastinal and hilar lymphadenopathy …”

Section: Introductionmentioning

confidence: 99%

“…Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality for nodal staging in lung cancer patients. [1][2][3][4][5] In addition, EBUS-TBNA is widely used for the diagnosis of benign conditions, for example, sarcoidosis related mediastinal and hilar lymphadenopathy. 6,7 The observation that certain histologic subtypes of nonsmall cell lung cancer (NSLC) respond differently to particular chemotherapeutic agents and the increasing use of targeted therapies, 8,9 have created a need for precise histologic characterization and molecular analysis for targeted mutations of small biopsy specimens obtained by EBUS-TBNA.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic value of tissue button technique for specimen accusation during endobronchial ultrasound‐guided transbronchial fine‐needle aspiration

Fruchter

Breslavsky

Brozgol

et al. 2017

Clinical Respiratory J

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The newly introduced TB technique provides valuable histological diagnostic material during EBUS-TBNA both malignant and benign conditions. Given its simplicity and its high diagnostic yield, TB should be considered to be used as one of the preferred specimen acquisition modalities during EBUS-TBNA specimen processing. Direct comparison to alternative tissue processing techniques during EBUS-TBNA should be explored in further randomized prospective studies.

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EBUS may arise as an initial time saving procedure in patients who are suspected to have small cell lung cancer

Abstract: EBUS-TBNA may be an initial diagnostic procedure in SCLC. Patients with only hilar/mediastinal masses without any endobronchial lesion could be directed to centers with the capability for performing EBUS-TBNA to have a rapid diagnosis without any time loss.

Cited by 7 publications

References 18 publications

Predicting delays in lung cancer diagnosis and staging

Predicting delays in lung cancer diagnosis and staging

EBUS: Faster, cheaper and most effective in lung cancer staging

The diagnostic value of tissue button technique for specimen accusation during endobronchial ultrasound‐guided transbronchial fine‐needle aspiration

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