Rapid On-Site Cytologic Evaluation During Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Nodal Staging in Patients With Lung Cancer

Should transbronchial needle aspiration and rapid on-site cytologic evaluation be performed before mediastinoscopy? “Analysis of 239 cases”

“…Mediastinal staging is of importance for planning the treatment of NSCLC patients but mediastinoscopy allows access to only a limited number of MLN stations (1,2,3,4,7). Transbronchial needle aspiration is less invasive than mediastinoscopy and allows access to a wider range of MLN stations (2,3,4,7,10,11).…”

“…Transbronchial needle aspiration is less invasive than mediastinoscopy and allows access to a wider range of MLN stations (2,3,4,7,10,11). [14] In our series, mediastinal staging of NSCLC was performed in 64 patients with TBNA-ROSE, which resulted in the change of therapy recommendation from curative surgery to neo-adjuvant chemotherapy or curative chemo-radiotherapy.…”

“…[2,3] Therefore, accurate MLN staging is critical for selecting patients suitable for surgery. [4] Mediastinoscopy remains the gold standard for mediastinal staging of NSCLC, but this procedure is associated with certain complications, such as bleeding, recurrent nerve damage, and thoracic duct injury. Particularly, remediastinoscopy after neoadjuvant chemotherapy or chemo-radiotherapy for N 2 disease have a higher complication rate than mediastinoscopy.…”

“…[1,3] Diagnostic yield of neoplasms can be improved with rapid on-site cytologic evaluation (ROSE) by a cytopathologist or endobronchial ultrasound (EBUS). [1,2,4] Transbronchial needle aspiration and rapid on-site cytologic evaluation can reduce risk, costs, morbidity, and anxiety for patients, as well as the time to definitive treatments. [1][2][3][4][5] Surgical resection is considered as the best treatment method in NSCLC; however, clinical evidence indicates that patients with mediastinal lymph node (MLN) metastasis have poor prognosis.…”

“…[1,2,4] Transbronchial needle aspiration and rapid on-site cytologic evaluation can reduce risk, costs, morbidity, and anxiety for patients, as well as the time to definitive treatments. [1][2][3][4][5] Surgical resection is considered as the best treatment method in NSCLC; however, clinical evidence indicates that patients with mediastinal lymph node (MLN) metastasis have poor prognosis. [2,3] Therefore, accurate MLN staging is critical for selecting patients suitable for surgery.…”