@article {CrombagP3564, author = {Laurence Crombag and Jos Stigt and Christophe Dooms and Kurt Tournoy and Jouke Annema}, title = {Systematic vs hit-and-run endosonographic staging of lung cancer}, volume = {44}, number = {Suppl 58}, elocation-id = {P3564}, year = {2014}, publisher = {European Respiratory Society}, abstract = {Introduction:Guidelines recommend endosonography for mediastinal nodal staging. The value of a systematic nodal evaluation vs targeted sampling of the suspected nodes based on CT-PET findings is unknown.Aim:To investigate whether systematic endosonographic staging (assessment of all nodal regions) results in improved loco-regional nodal staging compared to PET-CT directed assessment (ie targeted approach).Methods:A prospective, international multicenter study in patients with (suspected) Non-Small Cell Lung Cancer (NSCLC) and an indication for mediastinal nodal staging. Prior to endoscopy, nodal target(s) were defined based on CT-PET reports.Intervention:A systematic EBUS evaluation followed by systematic EUS-B (EBUS scope in esophagus). Both target nodes as well as sonographically suspected and/or nodes with a short axis greater than 8 mm were sampled. Surgery with nodal dissection was the reference standard.Results:80 patients with (suspected) NSCLC (mean age 65 years, 50 male) were investigated according to protocol. Final diagnosis was NSCLC, SCLC, benign and other in 68, 6, 4 and 2 patients, respectively. The prevalence of mediastinal nodal metastases was 33/80 (41\%). In 7 patients (9\%) systematic nodal staging resulted in an added value in comparison to the targeted approach (1 N1, 5 N2, 1 N3 disease). False negative findings were present in 6 patients.Conclusion and implications:Systematic endosonographic staging (assessment of all nodal regions) results in improved loco-regional staging compared to PET-CT directed hit-and-run approach and should be the preferred endoscopic staging strategy of NSCLC.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/44/Suppl_58/P3564}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }