Role of Computed Tomography and Mediastinoscopy in Preoperative Staging of Lung Carcinoma

Jp, Brion; Depauw, L.; Kuhn, Gisela; P, de Fracquen; Friberg, Julia; Rocmans,; Struyven, Julien

doi:10.1097/00004728-198505000-00011

Cited by 55 publications

(22 citation statements)

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“…However, several studies demonstrated that enlarged glands on CT scanning are not necessarily metastatic [7][8][9][10][11][12][13]. It was shown that histological proof is mandatory before a patient is judged inoperable [8]. In the present study, 59% of mediastinal lymph nodes larger than 1 cm on CT scanning were not found to be metastatic on pathological examination.…”

Section: Discussionmentioning

confidence: 41%

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Prospective evaluation of computed tomography and mediastinoscopy in mediastinal lymph node staging

Gdeedo

Schil²,

Corthouts³

et al. 1997

Eur Respir J

164

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Twenty five (25%) mediastinoscopies were positive and three were false-negative (3%). There were 29 false-positive CT scans and 12 false-negative. Overall sensitivity and specificity of CT were 63 and 57%, respectively, and of mediastinoscopy 89 and 100%, respectively. Positive and negative predictive values of CT were 41 and 77%, respectively, and of mediastinoscopy 100 and 96%, respectively. Accuracy of CT was 59% and of mediastinoscopy 97%. Accuracy of CT was lowest for left-sided and centrally located tumours, and for LN station 7.Even with current computed tomography scanners, sensitivity and specificity remain low. Although overall cost may increase, routine cervical mediastinoscopy is necessary for precise staging of non-small cell lung cancer, and subcarinal lymph nodes should be routinely sampled.

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Section: Discussionmentioning

confidence: 41%

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of computed tomography and mediastinoscopy in mediastinal lymph node staging

Gdeedo

Schil²,

Corthouts³

et al. 1997

Eur Respir J

164

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“…Two out of these were squa mous cell carcinomas. Recently, improved survival has been reported following surgical resection in selected patients with mediasti nal involvement of this type of carcinoma as compared with other lung tumors [10]. This finding further reduces the proportion of false-negative CT-scans in the present study.…”

Section: Discussionsupporting

confidence: 51%

Mediastinoscopy: Not Needed Preoperatively in CT-Negative Lung Carcinoma?

Liippo

Puhakka²,

Katevuo

et al. 1989

ORL

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The objective was to investigate the necessity of mediastinoscopy in preoperative staging of lung carcinoma in 57 operable patients. Noninvasive radiology was compared to mediastinoscopy and thoracotomy. Computed tomography (CT-scan) and mediastinoscopy were in agreement in 40 cases (70%). CT-scan was negative in 26 patients, of which 4 were false negatives. Mediastinoscopy is therefore of no benefit preoperatively for 85% (22 out of 26) of patients. Consequently, we have changed our staging policy and only patients with positive CT-scan are now subjected to mediastinoscopy.

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“…Despite high specificity (77-86%), sensitivity (49-66%) is low in evaluation of mediastinal lymph nodes with CT, (Brion et al, 1985;. Clinical data revealed that CT itself is not sufficient to identify mediastinal lymph node involvement in patients with NSCLC (Luke et al, 1986;Lowe et al, 1998;Schimmer et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Investigation of micrometastasis by cytokeratin staining in non-small cell lung cancer patients with tumor negative mediastinoscopic lymph node biopsies

Kaya¹,

Başoğlu²,

Büyükkarabacak³

et al. 2013

jecm

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Article HistoryReceived 21 / 03 / 2013 Accepted 09 / 04 / 2013To investigate micrometastasis by using epithelial cytokeratin marker in non-small cell lung cancer (NSCLC) patients with tumor negative mediastinoscopic lymph node biopsies. Micrometastasis were investigated by immunohistochemical staining in 20 patients who were diagnosed as NSCLC with ipsilateral mediastinal lymph nodes (RN2) in CT scan and with negative histopathologic mediastinoscopic lymph node biopsy (pN0). Frozen section was studied with hematoxylin-eosin (HE), a routine histopatological method in lymph nodes taken by mediastinoscopy and in absence of metastasis; resection was applied with thoracotomy in the same session. We studied micrometastasis in lymph nodes, which are taken out by mediastinoscopy and dissected during resection, using both HE and immunohistochemical staining with cytokeratin. All patients were male and median age was 60.9 (51-74) years. In 16 cases epidermoid carcinoma, in 2 cases adenocarcinoma and in 2 cases bronchioloalveoler carcinoma were diagnosed as histopathological types.Cervical mediastinoscopy was performed in 20 patients who were diagnosed as RN2 by thorax CT radiologically, and complete resection was done in pN0 patients. Sixty lymph nodes, 40 of them taken by mediastinoscopy and 20 taken during resection, were stained immunohistochemically in 20 NSCLC patients. Only one lymph node from a single patient was positive after staining. After postoperative staging, 18 patients were at a lower stage, one patient was at the same stage, and one patient with micrometastasis was at an advanced stage. Immunohistochemical staining may be useful in detecting micrometastasis in NSCLC. Standard cervical mediastinoscopy is still gold standard in preoperative staging. Efficiency can be increased by combining mediastinoscopy, a gold standard method in staging, with immunohistochemical methods.

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Role of Computed Tomography and Mediastinoscopy in Preoperative Staging of Lung Carcinoma

Cited by 55 publications

References 0 publications

Prospective evaluation of computed tomography and mediastinoscopy in mediastinal lymph node staging

Prospective evaluation of computed tomography and mediastinoscopy in mediastinal lymph node staging

Mediastinoscopy: Not Needed Preoperatively in CT-Negative Lung Carcinoma?

Investigation of micrometastasis by cytokeratin staining in non-small cell lung cancer patients with tumor negative mediastinoscopic lymph node biopsies

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