Usefulness of surgical staging after negative EBUS -staging in patients with lung cancer with clinical N0

Abstract

Introduction: this is no doubt, that an accurate staging is crucial for patients with non–small cell lung cancer. According to the last meta-analysis, the verification of negative results of EBUS in patients with N0-1 by mediastinoscopy in selected cases remains of value. The aim of our trial was to check the sensitivity of EBUS in cases of lung cancer staging in patients with clinical N0. Material: there was a prospective trial. Criteria for inclusion: lung cancer patients with clinical NO. Period of the trial: from January 2014 till December 2018. There 42 patients were enrolled in the trial.

Methods: EBUS staging were done in all cases by one operator. At least 3 punctures per one group and 3 groups were investigated. No ROSE. In all cases, only cytoblocks were done. Mediastinoscopy (3) or VAMLA (7) were done in 10 patients.

Results: there were 37 (88%) patients with NO after EBUS staging, 3 (7%) patients were with N3, 4 (9%) with NO. In 37 patients with negative EBUS staging, 10 surgical staging procedures were done in Group 1. And in 27 patients the curative surgery without surgical staging was done in Group 2. After surgical staging an additional 2 patients with N2 disease were revealed, no N3 disease. Final staging in Group 1 revealed in one case (14%) N2-disease, no patients after VAMLA. Group 2 – 3 (11%) patients with N2 disease. No statistical power.

Conclusion: EBUS staging in patients with lung cancer and clinical NO – is a useful method. The effectiveness of surgical staging procedure should be check in long-term results.