Abstract
Endobronchial Ultrasound (EBUS) is essential for the evaluation of mediastinal nodes in the diagnosis and staging of cancer. Our aim was to assess the diagnostic value of EBUS in histology-representative, disease-negative cases with an initial suspicion of malignancy.
We included every EBUS performed from 2008 to 2018 with the aim to evaluate mediastinal malignancy, when it resulted representative-negative (it sampled histology-valid lymphoid tissue with no microscopic disease). We considered true negative every representative-negative EBUS with either a subsequent 2 year clinical-radiological surveillance with no proved malignancy, or a subsequent malignancy-negative mediastinoscopy, and/or a subsequent malignancy-negative thoracotomy node excision.
A total of 616 EBUS were accomplished, 204 resulted representative-negative, 123 of which (81% Men; Median age 68) had a suspicion of malignancy (46% lung cancer). In 92 of the 123 cases we retrieved any data. 17 cases were conducted clinical-radiological surveillance with no proved malignancy; 71 cases were conducted mediastinoscopy, 11 of which diagnosed malignancy and 4 benign processes. Other 4 cases were conducted direct thoracotomy and 1 diagnosed mediastinal malignancy. In 45 of the remaining 56 disease-negative mediastinoscopy cases we retrieved any data. 5 cases were conducted clinical-radiological surveillance with no found malignancy, and 40 cases were conducted thoracotomy, 2 of which diagnosed mediastinal malignancy.
Thus, mediastinal malignancy was confirmed in 14 of 81 utterly studied negative-EBUS cases. The negative predictive value (NPV) of EBUS was 83%.
In conclusion, EBUS is valid for the evaluation of mediastinal nodes, with a high NPV for malignancy.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA321.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019