Outcomes of invasive mediastinal nodal staging versus positron emission tomography staging alone for early-stage non-small cell lung cancer treated with stereotactic body radiation therapy

Schonewolf, Caitlin; Verma, Vivek; Post, Carl M.; Berman, Abigail T.; Frick, Melissa A.; Vachani, Anil; Lin, Chi; Simone, Charles B.

doi:10.1016/j.lungcan.2017.07.005

Cited by 25 publications

(11 citation statements)

References 30 publications

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“…The comparison between imaging techniques and invasive methods in the mediastinal study causes controversy. According to Schonewolf et al (25) there would be no obvious advantages in invasive methods compared to the use of 18 F-FDG-PET/CT alone in the evaluation of mediastinal lymph nodes. In their experience, 236 patients were affected by NSCLC (a total of 257 lesions); of these, 180 patients were staged by single 18 F-FDG-PET/CT (199 lesions) while the other 56 patients (58 lesions) were subjected to invasive mediastinal nodal staging (IMNS), of which patients 52 underwent EBUS and 4 to mediastinoscopy.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): a diagnostic challenge for mediastinal lesions

et al. 2018

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Lung cancer is one of the most frequent neoplastic diseases. To date, most lung cancer is diagnosed at an advanced stage, making it difficult to choose the diagnostic and therapeutic strategy. Surgical resection represents the best therapeutic solution. However, the best results are obtained only in the early stages of the disease. Lymph node involvement conditions the treatment (surgical or non-surgical approach). Mediastinoscopy is an effective and widely used method for mediastinal staging but does not allow us to reach many mediastinal lymph nodes. Endobronchial ultrasound/transbronchial needle aspiration (EBUS-TBNA) allows us to reach more lymph nodes and is referred to as a first-choice exam for mediastinal staging.

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Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): a diagnostic challenge for mediastinal lesions

et al. 2018

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“…Surgical resection is the most effective treatment for now but the recurrence rate after having the surgery for 5 years is 30% [2]. Radiotherapy is also one of the optional treatments for patients with an unresectable area in early stage of lung cancer [3]. Unfortunately, only 16% of patients present with localized diseases at the time of initial diagnosis, and the vast majority of patients are diagnosed with regional (22%) or distant (57%) metastasis and lose the opportunity for surgery.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of diagnostic and prognostic value of miR-126 in non-small cell lung cancer

Sun¹,

Zhou²,

Yang³

et al. 2020

Bioscience Reports

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In recent years, many studies on the relationship between the expression of microRNA-126 (miR-126) and the diagnostic and prognostic value of non-small cell lung cancer (NSCLC) have been made, but the results were still controversial. The aim is to explore the expression of miR-126 and the diagnosis and prognosis value of NSCLC, and to provide relevant evidence for clinical diagnosis and treatment. Literature related to miR-126 and NSCLC were searched in PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang from the inception to February 2020. Stata 15.0 was used for meta-analysis. The diagnostic value data were used to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the prognostic value data were used to calculate the pooled risk ratio (hazard ratio, HR) of overall survival (OS) and its 95% confidence interval (95% CI). Thirteen studies were included, among which five were related to diagnosis containing 439 patients and 463 healthy controls, and eight related to prognosis containing 1102 patients. The results of miR-126 expression and diagnostic value of NSCLC showed that the pooled sensitivity was 0.83 (95% CI: 0.59–0.94), specificity = 0.83 (95% CI: 0.71–0.90), PLR = 4.78 (95% CI: 2.97–7.69), NLR = 0.20 (95% CI: 0.08–0.54), DOR = 23.48 (95% CI: 7.87–70.10), and the area under the summ ary receiver operating characteristic curve (SROC) was 0.89 (95% CI: 0.86–0.91). The results of prognostic value indicated that the expression of miR-126 was related to the OS of NSCLC (HR = 0.79, 95% CI: 0.63–0.98). In conclusion, the expression of miR-126 has medium diagnostic value, and it is related to the prognosis of patients with NSCLC, with poor prognosis of miR-126 low expression.

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“…This is similar to the sensitivity and NPV of 79-81% and 93%, respectively, achieved with invasive mediastinal staging via EBUS/EUS or mediastinoscopy (24). In a recent multicenter analysis of 233 patients with ES-NSCLC who received definitive treatment with SBRT, pretreatment staging with invasive mediastinal lymph node staging in addition to PET/CT (180 patients, 199 lesions) did not result in an increase in regional failures compared with PET/CT staging alone (56 patients, 58 lesions) (11% PET/CT vs. 21% PET + mediastinal staging, P>0.05) (25). Therefore, mediastinal staging without the use of invasive procedures may be a reasonable approach for regional lymph node assessment.…”

Section: Work-upmentioning

confidence: 95%

Medically inoperable stage I non-small cell lung cancer: best practices and long-term outcomes

Choi¹

2018

Transl. Lung Cancer Res

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Early-stage non-small cell lung cancer (ES-NSCLC) currently represents a minority of all NSCLC diagnoses but, with ongoing refinement and improvement of treatment approaches, is a group with increasing likelihood of long-term disease control and survival. A significant proportion of this population will not be optimal candidates for definitive surgical resection due to tumor characteristics, patient frailty, or comorbid status. The clinical evidence to support the use of stereotactic body radiation therapy (SBRT) in patients with medically inoperable stage I NSCLC is growing as long-term data are obtained. In this review, initial workup, SBRT delivery considerations, recent trial data, and post-treatment surveillance of this population are discussed.

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Outcomes of invasive mediastinal nodal staging versus positron emission tomography staging alone for early-stage non-small cell lung cancer treated with stereotactic body radiation therapy

Cited by 25 publications

References 30 publications

Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): a diagnostic challenge for mediastinal lesions

Endobronchial ultrasound-transbronchial needle aspiration (EBUS/TBNA): a diagnostic challenge for mediastinal lesions

Meta-analysis of diagnostic and prognostic value of miR-126 in non-small cell lung cancer

Medically inoperable stage I non-small cell lung cancer: best practices and long-term outcomes

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