Performance insights of endobronchial ultrasonography (EBUS) and mediastinoscopy for mediastinal lymph node staging in lung cancer

Visser, Margot P. J.; Grimbergen, I. van; Hölters, J.; Barendregt, W.B.; Vermeer, L.C.; Vreuls, Willem; Janssen, JP

doi:10.1016/j.lungcan.2021.04.003

Cited by 10 publications

(3 citation statements)

References 20 publications

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“…Every year, around 1.35 million people are diagnosed with the disease, with 1.18 million dying. This statistic is considerably higher than other cancers like breast and colon cancer, and the death rate in China and other countries is still rising [76]. The line between the lung tumour and the border tissue is blurry, during surgery.…”

Section: Lung Cancermentioning

confidence: 96%

A Review on Laser-Induced Breakdown Spectroscopy in Different Cancers Diagnosis and Classification

et al. 2022

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Due to the new demonstrations of Laser-induced breakdown spectroscopy (LIBS) applicability in a surprisingly wide variety of applications, the use of LIBS as a medical diagnostic tool is steadily gaining momentum. Especially in different cancer diseases, LIBS has the potential to become a fast and valuable analytical tool. We addressed LIBS equipment and quantitative analytical procedures, and signal enhancement techniques for improving element detection. For detailed aspects of applications, we reviewed the recent progress of LIBS in different cancer diseases diagnoses by using different tissues and medical fluid as samples. To fulfill the high demands in the medical industry and overcome the severe tissue sample problem, it is proposed that the chemometric and signal amplification techniques for quantitative analysis should be employed, and robust and effective LIBS devices should be developed. This overview of the different cancers by LIBS is meant to summarize the research performed to date and suggest some suitable advanced chemometrics techniques and effective LIBS devices, if successfully implemented, would be significantly beneficial to the medical field in the future.

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Section: Lung Cancermentioning

confidence: 96%

A Review on Laser-Induced Breakdown Spectroscopy in Different Cancers Diagnosis and Classification

et al. 2022

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“…It must, however, be noted that the EBUS expertise in other climes has advanced to the point that EBUS has completely replaced mediastinoscopy for mediastinal lymph node (N2) staging in lung cancer. 23 The limitations of our study include some loss of pertinent information (number of lymph nodes biopsied, lymph node stations biopsied) associated with retrospective studies. Secondly, our study was performed in a single institution with a single surgical group, which may bias the operative data.…”

Section: Discussionmentioning

confidence: 99%

Mediastinoscopy as a diagnostic tool in a South African tertiary hospital

Ofoegbu¹,

Swai²,

Moodley³

et al. 2022

S. Afr. j. surg.

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BACKGROUND: Mediastinoscopy is an effective and safe diagnostic tool for anterior mediastinal lesions. The study was done to assess the usefulness of mediastinoscopy as a diagnostic modality for mediastinal lesions. METHODS: A retrospective study of patients who had mediastinoscopy over 12 years at the Groote Schuur Hospital, Cape Town. Preoperative data, intraoperative and postoperative data were collected. RESULTS: The records of 115 patients were reviewed. Male to female ratio was 1.4:1 with a mean age of 48.5 (± 16.8) years. Preoperative computerised tomography (CT) scan was done in 98.3%. The most common indications for mediastinoscopy were mediastinal lymphadenopathy (87.8%) and anterior mediastinal mass (12.2%). Prior endobronchial ultrasound (EBUS) biopsy was done in 11.3%. All the patients had conventional cervical mediastinoscopy. Lung cancer staging accounted for 16.5% of the procedures. A biopsy was successfully done in 103 patients (89.6%). The most common lymph node station biopsied was 2R (55.7% of 76 patients), though the information on stations biopsied could not be ascertained in 25.2% of patients. The complication rate was 1.7 % (suprasternal haematoma and brachiocephalic artery injury). Histopathologic diagnoses were obtained in 89.5% (103/115 patients). Benign diagnoses accounted for 72.8% (75), while malignant diagnoses were 27.2% (28). Intensive care unit (ICU) stay and mechanical ventilation were required in 5% and 2.5% of patients, respectively. The median postoperative hospital stay was 2 days. There were no postoperative deaths. The median follow-up period was 14 days. CONCLUSION: Mediastinoscopy's diagnostic role is assured, still required and is safe with minimal morbidity and no mortality.

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“…Surgical staging is only available for selected cases. An additional mediastinoscopy cannot generally reduce the false negative rate by EBUS-TBNA, provided that EBUS-TBNA is performed by an experienced team [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Patterns of nodal spread in stage III NSCLC: importance of EBUS-TBNA and 18F-FDG PET/CT for radiotherapy target volume definition

Guberina¹,

Darwiche

Hautzel

et al. 2021

Radiat Oncol

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Purpose The aim of this study was to compare the pattern of intra-patient spread of lymph-node (LN)-metastases within the mediastinum as assessed by 18F-FDG PET/CT and systematic endobronchial ultrasound-guided transbronchial-needle aspiration (EBUS-TBNA) for precise target volume definition in stage III NSCLC. Methods This is a single-center study based on our preceding investigation, including all consecutive patients with initial diagnosis of stage IIIA-C NSCLC, receiving concurrent radiochemotherapy (12/2011–06/2018). Inclusion criteria were curative treatment intent, 18F-FDG PET/CT and EBUS-TBNA prior to start of treatment. The lymphatic drainage was classified into echelon-1 (ipsilateral hilum), echelon-2 (ipsilateral LN-stations 4 and 7) and echelon-3 (rest of the mediastinum, contralateral hilum). The pattern of spread was classified according to all permutations of echelon-1, echelon-2, and echelon-3 EBUS-TBNA findings. Results In total, 180 patients were enrolled. Various patterns of LN-spread could be identified. Skip lesions with an involved echelon distal from an uninvolved one were detected in less than 10% of patients by both EBUS-TBNA and PET. The pattern with largest asymmetry was detected in cases with EBUS-TBNA- or PET-positivity at all three echelons (p < 0.0001, exact symmetry test). In a multivariable logistic model for EBUS-positivity at echelon-3, prognostic factors were PET-positivity at echelon-3 (Hazard ratio (HR) = 12.1; 95%-CI: 3.2–46.5), EBUS-TBNA positivity at echelon-2 (HR = 6.7; 95%-CI: 1.31–31.2) and left-sided tumor location (HR = 4.0; 95%-CI: 1.24–13.2). There were significantly less combined ipsilateral upper (LN-stations 2 and 4) and lower (LN-station 7) mediastinal involvements (16.8% of patients) with EBUS-TBNA than with PET (38.9%, p < 0.0001, exact symmetry test). EBUS-TBNA detected a lobe specific heterogeneity between the odds ratios of LN-positivity in the upper versus lower mediastinum (p = 0.0021, Breslow-Day test), while PET did not (p = 0.19). Conclusion Frequent patterns of LN-metastatic spread could be defined by EBUS-TBNA and PET and discrepancies in the pattern were seen between both methods. EBUS-TBNA showed more lobe and tumor laterality specific patterns of LN-metastases than PET and skipped lymph node stations were rare. These systematic relations offer the opportunity to further refine multi-parameter risk of LN-involvement models for target volume delineation based on pattern of spread by EBUS-TBNA and PET.

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Performance insights of endobronchial ultrasonography (EBUS) and mediastinoscopy for mediastinal lymph node staging in lung cancer

Cited by 10 publications

References 20 publications

A Review on Laser-Induced Breakdown Spectroscopy in Different Cancers Diagnosis and Classification

A Review on Laser-Induced Breakdown Spectroscopy in Different Cancers Diagnosis and Classification

Mediastinoscopy as a diagnostic tool in a South African tertiary hospital

Patterns of nodal spread in stage III NSCLC: importance of EBUS-TBNA and 18F-FDG PET/CT for radiotherapy target volume definition

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