New Endoscopic Ultrasound (EUS) Applications in Lung Cancer: Evaluation of Patients with Negative Mediastinal CT and Re-Staging after Neoadjuvant Treatment

被引:2
|
作者
Fernandez-Esparrach, Gloria [1 ]
Sendino, Oriol [1 ]
Gines, Angels [1 ]
机构
[1] Univ Barcelona, Secc Endoscopia, Serv Gastroenterol, ICMDiM,Hosp Clin,IDIBAPS,CIBERehd, Barcelona, Spain
来源
ARCHIVOS DE BRONCONEUMOLOGIA | 2011年 / 47卷 / 08期
关键词
Lung cancer; Staging; Restaging; Adjuvant therapy; EUS; EUS-FNA; FINE-NEEDLE-ASPIRATION; COMPARING PERIOPERATIVE CHEMOTHERAPY; ENDOBRONCHIAL ULTRASOUND; INDUCTION THERAPY; REPEAT MEDIASTINOSCOPY; COMPUTED-TOMOGRAPHY; LYMPH-NODES; FDG-PET; STAGE; REMEDIASTINOSCOPY;
D O I
10.1016/j.arbres.2011.03.002
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
The main purpose of staging in non-small cell lung cancer (NSCLC) is to assess mediastinal lymph node involvement, with thoracic CT being the main non-invasive test for this. However, given that up to 15% of patients who show no mediastinal lymph node involvement in the CT have lymph node metastasis during surgery, other examinations are required. Endoscopic ultrasonography guided fine-needle aspiration (EUS-FNA) has shown to be able to detect advanced disease (metastatic mediastinal lymph nodes, adrenal metastasis, mediastinal invasion by the tumour) in approximately 25% of patients with a CT that suggested a non-advanced disease. Another situation in which CT has a very limited value is in the evaluation of the response to induction therapy, with its most limiting factor being its intrinsic inability to distinguish between a tumour and necrosis. In this context, EUS-FNA has shown to have a good performance, with a sensitivity, negative predictive value and precision of 75%, 67% and 83%, respectively. In conclusion, EUS-FNA may be considered a good alternative in the pre-operative staging of patients with NSCLC, with and without diseased mediastinal lymph nodes in CT, and could play an important role in the mediastinal re-staging of these patients by identifying a patient sub-group who might benefit from additional surgical treatment. (C) 2011 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.
引用
收藏
页码:410 / 414
页数:5
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