The Role of Extended Cervical Mediastinoscopy in Staging of Non-small Cell Lung Cancer of the Left Lung and a Comparison with Integrated Positron Emission.

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The Role of Extended Cervical Mediastinoscopy in Staging of Non-small Cell Lung Cancer of the Left Lung and a Comparison with Integrated Positron Emission Tomography and Computed Tomography: Does Integrated Positron Emission Tomography and Computed Tomography Reduce the Need for Invasive Procedures? Muzaffer Metin, MD, Necati Citak, MD, Adnan Sayar, MD, Atilla Pekcolaklar, MD, Huseyin Melek, MD, Abdulaziz Kök, MD, Atilla Gurses, MD Journal of Thoracic Oncology Volume 6, Issue 10, Pages 1713-1719 (October 2011) DOI: 10.1097/JTO.0b013e318225914e Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 PET/CT results of the patients with or without lymph node metastasis accessed by ECM. APW, aortopulmonary window; PET/CT, positron emission tomography/computed tomography; FN, false negative; TN, true negative; TP, true positive; FP, false positive; SCM, standard cervical mediastinoscopy; ECM, extended cervical mediastinoscopy; APW cN2, APW positive by PET/CT; APW cN0, APW negative by PET/CT; group 3, consisted of patients who had been classified as cN2 by mediastinoscopy and had mediastinal lymph node metastasis that could only be accessed by SCM, without APW lymph node metastasis (SCM positive/ECM negative). Sensitivity = TP/TP + FN = 7/7 + 6 = 53.8%; NPV = TN/TN + FN = 31/31 + 6 = 83.7%; accuracy = TP + TN/TP + TN + FN + FP = 7 + 31/7 + 31 + 6 + 3 = 80.8%; PPV = TP/TP + FP = 7/7 + 3 = 70%; and specificity = TN/TN + FP = 31/31 + 3 = 91.1%. Journal of Thoracic Oncology 2011 6, 1713-1719DOI: (10.1097/JTO.0b013e318225914e) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Histopathological findings of the patients after standard and extended cervical mediastinoscopy. SCM, standard cervical mediastinoscopy; ECM, extended cervical mediastinoscopy, *group 1, **group 2, ***group 3; sensitivity = TP/TP + FN = 9/9 + 4 = 69.2%; NPV = TN/TN + FN = 34/34 + 4 = 89.4%; Accuracy = TP + TN/TP + TN + FN + FP = 9 + 34/9 + 34 + 4 = 91.4%. FN, false negative; TN, true negative; TP, true positive; FP, false positive. Journal of Thoracic Oncology 2011 6, 1713-1719DOI: (10.1097/JTO.0b013e318225914e) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions