RT Journal Article
SR Electronic
T1 EBUS-TBNA for nodal restaging and relapse in lung cancer
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2754
VO 44
IS Suppl 58
A1 Enderle, Markus
A1 Hoffknecht, Petra
A1 May, Gabriela
A1 Schubert, Heiner
A1 Rüther, Stefan
A1 Fischer, Stefan
A1 Zardo, Patrick
A1 Dickgreber, Nicolas
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2754.abstract
AB PET-CT and EBUS are current standard procedures for mediastinal lymph node (ln) staging of patients (pat.) with lung cancer (BC). Few publications however focus on restaging and ln recurrence after previous therapy. In this single center retrospective study of a newly established department of respiratory medicine this subgroup is evaluated.From 08/11 to 01/14 we performed EBUS-TBNA in 25 pat. with BC under suspicion of ln recurrence or for restaging (n=20 NSCLC, n=5 SCLC). Primary staging resulted in UICC 7th edition I/II in n=9 pat. IIIa/b in n=13 and IV in n=3. Diagnostic workup included CT-scan in all pat. and PET-CT in n=20. In 14/25 pat. ln metastases could be confirmed, in 10 pat. by EBUS-TBNA and in 4 pat. by subsequent surgery. 2 of these finally resulted in pN1 and 2 pN2. A further pat. refused further diagnostic but had clinical progressive disease. Pat. with negative EBUS-TBNA result (11/25) received further follow up or continued tumor treatment without developing ln relapase in 6 pat.. In one pat. surgery confirmed pN0 status. Overall EBUS-TBNA had a sensitivity and specificity of 71,4% and 54,5%.13 of 25 pat. were initially staged UICC IIIa/b. Previous treatment in this subgroup comprised platinum based chemoradiation (n=10), neoadjuvant chemotherapy (n=2) and one resection. 9/13 underwent PET-CT, 5 of these 9 finally showing ln metastases. 2/5 show concordant avid ln in PET-CT. 3/5 showed false negative PET-CT. EBUS diagnosed correctly 4 of 7 finally confirmed malignant ln with a sensitivity and specificity of 57% and 46%. PET-CT shows a sensitivity of 40%.We consider EBUS-TBNA as a reliable method for confirming malignancy in pat. with known BC. Negative TBNA results however need to undergo surgical workup.