The practice of cardiothoracic surgeons in the perioperative staging of non-small cell lung cancer.

Abstract

41 surgeons said that they would routinely do computed tomography, 68 indicated that they would do a mediastinoscopy if the computed tomography showed enlarged nodes. This suggests that some surgeons will undertake mediastinal exploration if

Chemotherapy for patients with non-small cell lung cancer: the surgical setting of the Big Lung Trial1

“…This may unfortunately reflect inaccurate or incomplete intraoperative lymph node staging. It has been noted previously [5] that there has been a deficiency in the UK practice of lymph node sampling at operation when 45% of surgeons did not resect or sample macroscopically normal lymph nodes. A recent update of this survey [6] in 2002 found little improvement in the UK practice of intraoperative nodal staging with extreme variability between surgeons.…”

Video-assisted thoracic surgery systematic mediastinal nodal dissection and stage migration: impact on clinical pathway

“…This may be due to a less aggressive approach in treatment, especially N2 disease. There are no data in the literature to reflect on the current practice of SND in the UK; however, a study conducted by Tsang and Watson in 1992 [12] suggested that 51% of UK thoracic surgeons did not sample mediastinal nodes routinely. Conversely, Goldstraw (Royal Brompton Hospital) has advocated as early as 1996 the routine use of SND as the method of choice to stage the mediastinum [13].…”

Prospective population-based study on the survival of patients with lung cancer

“…The relatively good survival of the patients treated surgically in the present series probably reflects better preoperative staging. However, the practice of cardiothoracic surgeons in perioperative staging is often inadequate, which may overestimate the accuracy of preoperative evaluation [17]. A change in stage is more likely when patients are investigated more extensively, with more patients being categorized as having an advanced stage and fewer as having earlier disease.…”