Survival Duration Among Patients with Lung Cancer Staged by Bronchoscopic Needle Aspiration

Endobronchial Ultrasound of the Airways and the Mediastinum

“…Involvement of the lymph nodes by tumor is correctly diagnosed in only 50%; 25% are false positive (overstaged) and 25% false negative (understaged), which has also been confirmed by others [6]. As routine mediastinoscopy is negative in 60%, and 16% of those are also false negative, some authors advise transbronchial needle aspiration of the hilar and mediastinal lymph nodes to diagnose extensive mediastinal tumor infiltration and prevent unnecessary explorative thoracotomies [7,8]. In conclusion, there is a need to improve the diagnostic procedures for these structures.…”

“…We assume that this is due to the high rate of unspecific alterations, such as inflammatory reactions in postobstructive pneumonia, silicotic or specific scar formation and other pathological reactions which cause alterations in the internal structure. As the importance of transbronchial/transtracheal needle aspiration has been proven for staging of regional lymph nodes [7,8,38] the addition of endobronchial ultrasound for improvement of these procedures has been investigated. Preliminary results showed that prior or simultaneous ultrasonography may reduce the number of attempts and improve results [42].…”

Endobronchial Ultrasound (EBUS) – Assessment of a New Diagnostic Tool in Bronchoscopy for Staging of Lung Cancer

“…Thus, EBUS will play an essential role in detection and treatment of early lung cancer as a tool for local staging after detection by sputum cytology and localization by autofluorescence because therapeutic decisions in these cases are made on the basis of endobronchial extent, infiltration of the tracheobronchial wall, and involvement of local lymph nodes [15,18]. For assessment of infiltration of the hilar and mediastinal lymph nodes, exact localization is necessary prior to transbronchial needle aspiration (TBNA) [7]. Defining size according to longitudinal and cross diameter, analysis of the internal structure and relation to the central airways and the mediastinal structures are important features that can be analyzed by EBUS.…”

Endobronchialer Ultraschall (EBUS) zum lokalen T- und Lymphknotenstaging bei zentralem Bronchialkarzinom

“…Entscheidend mitbeeinflusst wird die Prognose des Bronchialkarzinoms durch den Befall regionärer und überregionärer Lymphknotenstationen [6,8,26]. Die reine Beurteilung der Lymphknoten über ihre Größe in der Computertomographie und das damit verbundene N-Staging ergeben aufgrund einer sehr hohen Rate unspezifischer Veränderungen durch postobstruktive Pneumonien, silikotische oder tuberkulöse Narben und andere pathologische Veränderungen ebenfalls ein deutlich eingeschränkt verwertbares N-Staging [3,18,20,23].…”