Original articleGeneral thoracicEndobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Differentiating N0 Versus N1 Lung Cancer
Section snippets
Patients and Methods
The EBUS-TBNA database of the Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan, from April 2003 to June 2008 was reviewed, and the results of EBUS-TBNA in patients with potentially resectable clinical N0 or N1 NSCLC based on noninvasive staging modalities (computed tomography [CT] scan, positron emission tomography [PET] scan) were analyzed. The primary tumor and lymph node status was classified according to the international TNM staging system
Results
From April 2003 to June 2008, a total of 981 patients underwent EBUS-TBNA, of which 163 patients (mean age, 68 years; 120 male) met the study criteria and were included in the analysis. The final pathologic diagnosis of the primary tumor consisted of adenocarcinoma in 104, squamous cell carcinoma in 49, large cell neuroendocrine carcinoma in 8, and small cell carcinoma in 2. The clinical N staging based on imaging before EBUS-TBNA was cN0 in 94 patients and cN1 in 69 patients (Table 1). Of the
Comment
In the current study, we were able to demonstrate that EBUS-TBNA can accurately stage the hilar and interlobar lymph nodes to differentiate between N0 and N1 patients in potentially resectable lung cancer patients. Among the 163 patients who underwent EBUS-TBNA for lymph node staging, the majority of the patients (126 patients, 77.3%) had pathologic N0 disease without any evidence of lymph node metastases, and of note, all 163 patients had normal mediastinum based on CT and PET scans. Even
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