PT  - JOURNAL ARTICLE
AU  - Markus Hofer
AU  - Ivo Tosoni
AU  - Dieter Erdin
AU  - Felix Grieder
AU  - Hans Gelpke
AU  - Thomas Hess
TI  - Accuracy of endobronchial ultrasound (EBUS) for evaluation of N2/3 disease in lung cancer: Experience over six years
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P3726
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P3726.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P3726.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Introduction: Endobronchial ultrasound (EBUS) is the standard procedure for mediastinal staging in lung cancer with good accuracy in expert centres. The initial learning curve is well known but not the effect of long term experience on diagnostic yield.Methods: Analysis of all EBUS done at our institution for staging of LC from 3/2007 to 9/2013. Data, including procedure time were prospectively registered. Stadium IV diseases or N1/2 diseases without surgical confirmation were excluded. All investigations were done under conscious sedation and with rapid on-site cytology.Results: 261 patients (mean age 66±10 years) were evaluated. 152 patients (58%) finally had N2/3 disease. 10/261 patients (3.8%) had a false negative EBUS. Sensitivity, specificity and negative predictive value (NPV) of EBUS were 93%, 100% and 92%, respectively. Sensitivity and NPV increased over time from 92% and 91% in the first 130 investigations to 95% and 93% afterward. Six of ten patients with false negative EBUS had a false negative PET/CT too, four had only a micrometastasis. Seven patients were evaluated after neoadjuvant treatment, four were true negative, two true positive and one false positive (micrometastasis). Median procedure time for EBUS was 26 minutes (1st/3st 17/40 minutes) with median two evaluated lymph nodes (range 1-7).Conclusion: EBUS has a very good accuracy for the evaluation of the N2/3 disease in lung cancer. Over time, sensitivity and NPV steadily increased from 92% and 91% to 95% and 93% with improving results beyond 130 procedures. EBUS can easily and safely be performed under conscious sedation within reasonable time.