The Yield of Endoscopic Ultrasound in Lung Cancer Staging: Does Lymph Node Size Matter?  Kurt G. Tournoy, MD, Frédéric De Ryck, MD, Lieve Vanwalleghem,

Slides:



Advertisements
Similar presentations
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.
Advertisements

Endoscopic Ultrasound-Guided Fine Needle Aspiration of Mediastinal Lymph Node in Patients With Suspected Lung Cancer After Positron Emission Tomography.
PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma  Kemp H Kernstine, MD, PhD, William Stanford, MD, Brian F Mullan,
Epidemiology of Environmental Exposure and Malignant Mesothelioma
The eighth edition TNM stage classification for lung cancer: What does it mean on main street?  Frank C. Detterbeck, MD  The Journal of Thoracic and Cardiovascular.
Endosonography Versus Mediastinoscopy in Mediastinal Staging of Lung Cancer: Systematic Review and Meta-Analysis  Inderpaul Singh Sehgal, MD, DM, Sahajal.
Prognostic Significance of the Number of Lymph Nodes Removed at Lobectomy in Stage IA Non-small Cell Lung Cancer  Sai-Hong Ignatius Ou, MD, PhD, Jason.
It is not just about surgery versus stereotactic ablative radiotherapy, it is about curing as many patients with lung cancer as possible  Alessandro Brunelli,
Endoscopic and Endobronchial Ultrasonography According to the Proposed Lymph Node Map Definition in the Seventh Edition of the Tumor, Node, Metastasis.
Epidemiology of Environmental Exposure and Malignant Mesothelioma
Endobronchial ultrasonography (EBUS)—Its role in staging of non–small cell lung cancer and who should do it?  Rafael S. Andrade, MD, David D. Odell, MD,
Endoscopic ultrasound is inadequate to determine which T1/T2 esophageal tumors are candidates for endoluminal therapies  Edward J. Bergeron, MD, Jules.
A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph.
Transesophageal biopsy of mediastinal and pulmonary tumors by means of endoscopic ultrasound guidance  Michael Hünerbein, MD, Bijan Michael Ghadimi, MD,
Joachim Pfannschmidt, MD, Hans Hoffmann, MD, Hendrick Dienemann, MD 
Endoscopic ultrasound-guided fine needle aspiration and endobronchial ultrasound- guided transbronchial needle aspiration: Are two better than one in mediastinal.
Transesophageal Ultrasonography for Lung Cancer Staging: Learning Curves of Pulmonologists  Lars Konge, MD, PhD, Jouke Annema, MD, PhD, Peter Vilmann,
A New Biomarker Panel in Bronchoalveolar Lavage for an Improved Lung Cancer Diagnosis  María Uribarri, PhD, Itsaso Hormaeche, PhD, Rafael Zalacain, MD,
Complete Response Achieved 1 Year after a Single Administration of Nivolumab in a Patient with Lung Adenocarcinoma with Negative Expression of PD-L1 
MAGE qPCR Improves the Sensitivity and Accuracy of EBUS-TBNA for the Detection of Lymphatic Cancer Spread  Beatrix Cucuruz, MD, Sebastian Dango, MD, Vindi.
New Endobronchial Ultrasound Imaging for Differentiating Metastatic Site Within a Mediastinal Lymph Node  Takahiro Nakajima, MD, PhD, Masato Shingyouji,
Characterization of Mediastinal Lymph Node Physiology In Vivo by Optical Spectroscopy during Endoscopic Ultrasound-Guided Fine Needle Aspiration  Stephen.
The Impact of Superior Mediastinal Lymph Node Metastases on Prognosis in Non-small Cell Lung Cancer Located in the Right Middle Lobe  Yukinori Sakao,
Atypical Pleuropulmonary Tuberculosis Mimicking a Malignant Disease
Frank Detterbeck, MD  Journal of Thoracic Oncology 
Lung Adenocarcinoma with Ipsilateral Breast Metastasis: A Simple Coincidence?  Hsu-Ching Huang, MD, Jen-Fan Hang, MD, Mei-Han Wu, MD, Teh-Ying Chou, MD,
Nikolaas De Maeyer, MD, Walter De Wever, MD, PhD, Christophe M
Esophageal Ultrasound-Controlled Fine Needle Aspiration for Staging of Mediastinal Lymph Nodes in Patients with Resectable Lung Cancer: Do We Always See.
João Luis Sandri, MD, Fanilda S
Endobronchial Ultrasonography: Current Status and Future Directions
Mediastinal Lymph Node Examination and Survival in Resected Early-Stage Non– Small-Cell Lung Cancer in the Surveillance, Epidemiology, and End Results.
Diagnosis of Mediastinal Adenopathy—Real-Time Endobronchial Ultrasound Guided Needle Aspiration versus Mediastinoscopy  Armin Ernst, MD, FCCP, Devanand.
Utility of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis of Mediastinal Masses of Unknown Etiology  Kazuhiro Yasufuku,
A Practical Guide of the Southwest Oncology Group to Measure Malignant Pleural Mesothelioma Tumors by RECIST and Modified RECIST Criteria  Anne S. Tsao,
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.
Association between Congenital Lung Malformations and Lung Tumors in Children and Adults: A Systematic Review  Arianna Casagrande, MD, Federica Pederiva,
Mandeep S. Sawhney, Robert A. Kratzke, Frank A. Lederle, Amy M
Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Lymph Node Staging in Patients with Non-small Cell Lung Cancer in Nonoperable Patients.
Elizabeth B. Gottlin, PhD, Rex C. Bentley, MD, Michael J
Frequency of Lymph Node Metastasis According to the Size of Tumors in Resected Pulmonary Adenocarcinoma with a Size of 30 mm or Smaller  Yangki Seok,
Cost-Benefit of Minimally Invasive Staging of Non-small Cell Lung Cancer: A Decision Tree Sensitivity Analysis  Daniel P. Steinfort, MBBS, FRACP, Danny.
Appropriateness of Surgical Approach in Black Patients with Lung Cancer—15 Years Later, Little Has Changed  Emanuela Taioli, MD, PhD, Raja Flores, MD 
Positron Emission Tomography 18F-Fluorodeoxyglucose Uptake and Prognosis in Patients with Surgically Treated, Stage I Non-small Cell Lung Cancer: A Systematic.
Endobronchial Ultrasound-Guided Fine-Needle Aspiration of Mediastinal Lymph Nodes: A Single Institution's Early Learning Curve  Shawn S. Groth, MD, Bryan.
ALK Translocation in Non-small Cell Lung Cancer with Adenocarcinoma and Squamous Cell Carcinoma Markers  Samuel J. Klempner, MD, David W. Cohen, MD, Daniel.
A Systematic Review of Restaging After Induction Therapy for Stage IIIa Lung Cancer: Prediction of Pathologic Stage  Sara de Cabanyes Candela, MD, Frank.
Matthew Reichert, MD, Eric S. Bensadoun, MD 
The impact of lymph node station on survival in 348 patients with surgically resected malignant pleural mesothelioma: Implications for revision of the.
Frequency and Prognostic Significance of Preoperatively Detected Enlarged Regional Lymph Nodes in Patients with Pathological Stage I Non-small Cell Lung.
Endobronchial Ultrasound versus Mediastinoscopy for Mediastinal Nodal Staging of Non–Small-Cell Lung Cancer  Sang-Won Um, MD, PhD, Hong Kwan Kim, MD,
T4 or MI? Journal of Thoracic Oncology Volume 6, Issue 3, (March 2011)
Pulmonary Resection for Metastases from Colorectal Cancer
Distribution and Likelihood of Lymph Node Metastasis Based on the Lobar Location of Nonsmall-Cell Lung Cancer  Robert J. Cerfolio, MD, Ayesha S. Bryant,
Transesophageal Ultrasound-Guided Fine-Needle Aspiration for the Mediastinal Restaging of Non-small Cell Lung Cancer  Martin B. von Bartheld, MSc, Michel.
International Thymic Malignancies Interest Group: A Way Forward
Tetsuzo Tagawa, MD, Miyuki Takasu, MD, Teruyoshi Ishida, MD 
EBUS-TBNA for the Clarification of PET Positive Intra-Thoracic Lymph Nodes—an International Multi-Centre Experience  Robert C. Rintoul, FRCP, PhD, Kurt.
Wedge Resection for Non-small Cell Lung Cancer in Patients with Pulmonary Insufficiency: Prospective Ten-Year Survival  John P. Griffin, MD, Charles E.
Transesophageal Ultrasonography for Lung Cancer Staging: Learning Curves of Pulmonologists  Lars Konge, MD, PhD, Jouke Annema, MD, PhD, Peter Vilmann,
Who should decide margin length in pulmonary excision of lung cancer?
Impact of Information on Quality of Life and Satisfaction of Non-small Cell Lung Cancer Patients: A Randomized Study of Standardized versus Individualized.
Surveillance Epidemiology and End Results Evaluation of the Role of Surgery for Stage I Small Cell Lung Cancer  James B. Yu, MD, Roy H. Decker, MD, PhD,
Mark I. Block, MD  The Annals of Thoracic Surgery 
Nodal Recurrence of Pulmonary Carcinoid 30 Years After Primary Resection  Abdel-Mohsen Hamad, MD, Giovanna Rizzardi, MD, Giuseppe Marulli, MD, Federico.
Farhood Farjah, MD, MPH, David R. Flum, MD, MPH, Scott D
Patterns-of-Care for Thoracic Stereotactic Body Radiotherapy among Practicing Radiation Oncologists in the United States  Megan E. Daly, MD, Julian R.
Rogerio C. Lilenbaum, MD, John Cashy, PhD, Thomas A
Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis of Intrapulmonary Lesions  Takahiro Nakajima, MD, Kazuhiro Yasufuku,
Endoscopic ultrasound in lung cancer patients with a normal mediastinum on computed tomography  Michael B Wallace, MD, James Ravenel, MD, Mark I Block,
Survival of Patients With Unsuspected pN2 Non-Small Cell Lung Cancer After an Accurate Preoperative Mediastinal Staging  Carme Obiols, MD, Sergi Call,
Presentation transcript:

The Yield of Endoscopic Ultrasound in Lung Cancer Staging: Does Lymph Node Size Matter?  Kurt G. Tournoy, MD, Frédéric De Ryck, MD, Lieve Vanwalleghem, MD, Marleen Praet, MD, Frank Vermassen, MD, Georges Van Maele, PhD, Jan P. van Meerbeeck, MD  Journal of Thoracic Oncology  Volume 3, Issue 3, Pages 245-249 (March 2008) DOI: 10.1097/JTO.0b013e3181653cbb Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Yield and impact of EUS-FNA in lung cancer patients. Patient flow chart. Patients were allocated to group A when no enlarged MLN were seen on the CT scan. Patients were allocated to group B when at least one enlarged (short axis at least 10 mm) MLN was seen on the CT scan. All patients underwent EUS-FNA and in case no malignancy was shown in the MLN, a referral for surgical mediastinal exploration followed (mainly cervical mediastinoscopy). The prevalence of N2/N3 is shown in the upper left corner of the cross-tables (p < 0.001 group A versus B). Test characteristics including sensitivity and NPV do not differ between groups A and B. Avoided surgery for mediastinal exploration was statistically higher in group B (p < 0.001). MLN, mediastinal lymph nodes; Se, sensitivity; Sp, specificity; PPV, positive predictive value; NPV, negative predictive value. Values given as percent with (95% CI). Journal of Thoracic Oncology 2008 3, 245-249DOI: (10.1097/JTO.0b013e3181653cbb) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 EUS-FNA and corresponding surgico-pathologic verification. Left panel, EUS-FNA of MLN 4L (aorto-pulmonary window). The fine needle is placed into the center of the MLN. The cytology of the fine-needle aspiration was negative. Right panel, Surgico-pathologic verification by mediastinoscopy. The normal parenchyma of the MLN is characterized by lymphocytes (deep purple dots) and antraco-silicotic pigment in the macrophages (dark brown color). In the right upper corner (arrow), a discrete but clear solitary tumor islet is present, situated in the subcapsular sinusoidal space of the MLN (H&E staining; magnification 200×). Journal of Thoracic Oncology 2008 3, 245-249DOI: (10.1097/JTO.0b013e3181653cbb) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions