RT Journal Article
SR Electronic
T1 Combined ultrasound-guided needle aspiration in restaging of the non-small-cell lung cancer - A three years experience
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3260
VO 40
IS Suppl 56
A1 Artur Szlubowski
A1 Stanislaw Orzechowski
A1 Jerzy Soja
A1 Juliusz Pankowski
A1 Anna Obrochta
A1 Magdalena Jakubiak
A1 Wojciech Czajkowski
A1 Marcin Zielinski
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/3260.abstract
AB Objectives: The aim of the prospective study was to assess the diagnostic yield of the combined approach – endobronchial (EBUS) and endoscopic (EUS) ultrasound-guided needle aspiration (CUS-NA) in restaging of the non-small-cell lung cancer (NSCLC) patients after neo-adjuvant therapy.Methods: In a consecutive group of NSCLC patients with pathologically confirmed N2 disease, who underwent neo-adjuvant chemotherapy, CUS-NA was performed. All negative patients underwent subsequently the transcervical extended bilateral mediastinal lymphadenectomy (TEMLA) as a confirmatory test.Results: 73 patients underwent restaging CUS-NA from Jan. 2009 to Dec. 2011. There were 123 mediastinal lymph nodes biopsied (stations: 2R – 4, 4R – 24, 2L – 3, 4L – 27, 7 – 61, 8 – 4). CUS-NA revealed metastatic lymph node involvement in 21/73 patients (28.8%). In 52 (71.2%) patients with negative or uncertain CUS-NA, who underwent subsequent TEMLA metastatic nodes were found in 13 patients (17.8%) and there was “minimal N2” in 8 out of them. In 7 patients CUS-NA occurred to be false-negative in the right paratracheal stations 2R and 4R, only accessible for EBUS. A diagnostic sensitivity, specificity, accuracy, PPV and NPV of the restaging CUS-NA was 62% (95% CI – 60–90), 95% (95% CI – 85–97), 80%, 91% (95% CI – 80–100) and 74% (95% CI – 71–91), respectively. No complications of CUS-NA were observed.Conclusions: CUS-NA is a reasonable and safe technique for mediastinal restaging in NSCLC patients, and after our data, in patients with negative results of the combined endoscopic technique, a surgical restaging of the mediastinum might not be mandatory.