Should all patients with non-small cell lung cancer who are surgical candidates have cervical mediastinoscopy preoperatively?

Ghosh, Shilajit; Nanjiah, Prakash; Dunning, Joel

doi:10.1510/icvts.2005.122838

Cited by 9 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the ESTS guidelines, for centrally located lung tumors exploration of mediastinal lymph nodes is indicated [21]. The false-negative rates of CT and PET imaging for mediastinal staging are high for patients with a centrally located lung tumor (20 % -25 % and 24 % -83 %, respectively) [13,49].…”

Section: Introductionmentioning

confidence: 99%

Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS)

et al. 2015

View full text Add to dashboard Cite

This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE), produced in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). It addresses the benefit and burden associated with combined endobronchial and esophageal mediastinal nodal staging of lung cancer. The Scottish Intercollegiate Guidelines Network (SIGN) approach was adopted to define the strength of recommendations and the quality of evidence. The article has been co-published with permission in the European Journal of Cardio-Thoracic Surgery and the European Respiratory Journal. Combined endosonography EBUS-TBNA and EUS-(B)-FNA combined Complete mediastinal nodal staging All nodes evaluated (in contrast to only analysis of suspected nodes based on CT and/or PET imaging) Targeted mediastinal nodal staging Evaluation of the node(s) that is (are) suspicious on CT and/or PET Centrally located lung tumor Lung tumor located within the inner third of the chest Peripherally located lung cancer Lung tumor located within the outer two thirds of the chest Lymph node(s) suspicious for malignancy (abnormal mediastinum) Node with a short axis (> 10 mm) and/or that is FDG-PET-avid Vilmann Peter et al. Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer

show abstract

Section: Introductionmentioning

confidence: 99%

Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS)

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Cervical mediastinoscopy is recommended in patients with resectable NSCLC and N0 disease on CT scan except from those with a T1 squamous cell tumor with N0 disease on CT scan [4].…”

Section: Chest Ct Scanmentioning

confidence: 99%

ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer

Leyn

Lardinois

Schil

et al. 2007

European Journal of Cardio-Thoracic Surgery

452

314

View full text Add to dashboard Cite

Accurate preoperative staging and restaging of mediastinal lymph nodes in patients with non-small cell lung cancer (NSCLC) is of paramount importance. It will guide choices of treatment and determine prognosis and outcome. Over the last years, different techniques have become available. They vary in accuracy and procedure-related morbidity. The Council of the ESTS initiated a workshop on preoperative mediastinal lymph node staging. This resulted in guidelines for primary staging and restaging. For primary staging, mediastinoscopy remains the gold standard for the superior mediastinal lymph nodes. Invasive procedures can be omitted in patients with peripheral tumors and negative mediastinal positron emission tomography (PET) images. However, in case of central tumors, PET hilar N1 disease, low fluorodeoxyglucose uptake of the primary tumor and LNs > or = 16 mm on CT scan, invasive staging remains indicated. PET positive mediastinal findings should always be cyto-histologically confirmed. Transbronchial needle aspiration (TBNA), ultrasound-guided bronchoscopy with fine needle aspiration (EBUS-FNA) and endoscopic esophageal ultrasound-guided fine needle aspiration (EUS-FNA) are new techniques that provide cyto-histological diagnosis and are minimally invasive. Their specificity is high but the negative predictive value is low. Because of this, if they yield negative results, an invasive surgical technique is indicated. However, if fine needle aspiration is positive, this result may be valid as proof for N2 or N3 disease. For restaging, invasive techniques providing cyto-histological information are advisable despite the encouraging results supported with the use of PET/CT imaging. Both endoscopic techniques and surgical procedures are available. If they yield a positive result, non-surgical treatment is indicated in most patients.

show abstract

“…Similarly, if no enlarged lymph nodes are found on CT, but the FDG-PET/CT findings in the mediastinal nodes are positive, invasive mediastinal staging is needed. Ghosh et al reported that CT and FDG-PET/CT may both be falsely negative (CT: 20–25%, FDG-PET/CT: 24–83%) in patients with a central tumor [ 68 ]. Therefore, invasive mediastinal staging is especially recommended for patients with central and higher-stage tumors (i.e., evidence of clinical N1 disease).…”

Section: Predictive Value Of Fdg-pet/ct For the Detection Of Lymphmentioning

confidence: 99%

Recent and Current Advances in FDG-PET Imaging within the Field of Clinical Oncology in NSCLC: A Review of the Literature

Kaseda¹

2020

Diagnostics

View full text Add to dashboard Cite

Lung cancer is the leading cause of cancer-related deaths around the world, the most common type of which is non-small-cell lung cancer (NSCLC). Computed tomography (CT) is required for patients with NSCLC, but often involves diagnostic issues and large intra- and interobserver variability. The anatomic data obtained using CT can be supplemented by the metabolic data obtained using fluorodeoxyglucose F 18 (FDG) positron emission tomography (PET); therefore, the use of FDG-PET/CT for staging NSCLC is recommended, as it provides more accuracy than either modality alone. Furthermore, FDG-PET/magnetic resonance imaging (MRI) provides useful information on metabolic activity and tumor cellularity, and has become increasingly popular. A number of studies have described FDG-PET/MRI as having a high diagnostic performance in NSCLC staging. Therefore, multidimensional functional imaging using FDG-PET/MRI is promising for evaluating the activity of the intratumoral environment. Radiomics is the quantitative extraction of imaging features from medical scans. The chief advantages of FDG-PET/CT radiomics are the ability to capture information beyond the capabilities of the human eye, non-invasiveness, the (virtually) real-time response, and full-field analysis of the lesion. This review summarizes the recent advances in FDG-PET imaging within the field of clinical oncology in NSCLC, with a focus on surgery and prognostication, and investigates the site-specific strengths and limitations of FDG-PET/CT. Overall, the goal of treatment for NSCLC is to provide the best opportunity for long-term survival; therefore, FDG-PET/CT is expected to play an increasingly important role in deciding the appropriate treatment for such patients.

show abstract

Should all patients with non-small cell lung cancer who are surgical candidates have cervical mediastinoscopy preoperatively?

Cited by 9 publications

References 8 publications

Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS)

Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS)

ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer

Recent and Current Advances in FDG-PET Imaging within the Field of Clinical Oncology in NSCLC: A Review of the Literature

Contact Info

Product

Resources

About