PT  - JOURNAL ARTICLE
AU  - Naur, Therese Maria Henriette
AU  - Konge, Lars
AU  - Clementsen, Paul Frost
TI  - Endobronchial ultrasound guided biopsy (EBUS–TBNA) for staging of patients with lung cancer without mediastinal involvement at positron emission tomography-computed tomography (PET-CT)
AID  - 10.1183/13993003.congress-2016.PA2041
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA2041
VI  - 48
IP  - suppl 60
4099  - https://publications.ersnet.org//content/48/suppl_60/PA2041.short
4100  - https://publications.ersnet.org//content/48/suppl_60/PA2041.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Background: Accurate staging of lung cancer is mandatory for the treatment plan, which is curative only in cases of localized disease. Previous studies suggest that endobronchial ultrasound with real-time guided transbronchial needle aspiration (EBUS-TBNA) is unnecessary when positron emission tomography-computed tomography (PET-CT) shows no mediastinal involvement.Objectives: The aim of the study was to investigate how often EBUS-TBNA resulted in a clinically relevant upstaging of the disease in patients with suspected or proven lung cancer and no mediastinal involvement at PET-CT.Methods: A total of 981 consecutive patients from 2009 to 2014 were referred for preoperative EBUS-TBNA. We included 219 patients without involvement of the mediastinum at PET-CT (154 N0 and 65 N1).Results: Of the 219 patients, 16 (7.3 %) were upstaged to N2 or N3 by EBUS-TBNA. Of these 16 patients, 14 were originally classified as N1 on PET-CT. Thus of the included 65 N1-patients, 21.5 % were upstaged to N2 or N3 after EBUS-TBNA. This was the case for only 1.3 % (2 patients) of the 154 N0-patients.Of the 219 included patients, 135 were referred for operation without mediastinal spread on either PET-CT or EBUS, and 13 of these proved to be N2 or N3 (9.6 %).Conclusions: The overall probability of a clinically relevant upstaging by EBUS-TBNA in patients without signs of spread to the mediastinum judged on PET-CT was 7.3 %. The probability was 1.3 % in patients classified as N0 and 21.5 % in patients classified as N1. The risk of overlooking N2 or N3 disease after both PET-CT and EBUS-TBNA was 9.6 %.