The validity of preoperative lymph node staging guidelines of European Society of Thoracic Surgeons in non-small-cell lung cancer patients☆

Günlüoğlu, Mehmet Zeki; Melek, Hüseyin; Medetoglu, Baris; Demir, Adalet; Kara, H. Volkan; Dinçer, Seyyit İbrahim

doi:10.1016/j.ejcts.2010.11.030

Cited by 19 publications

(12 citation statements)

References 15 publications

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“…Another reason for the higher positive rate may have been the differences in the histologic classifications of the population. In our study, the rate of squamous cell carcinoma was lower (19.5%) and that of adenocarcinoma higher (68.1%) than in the previous studies [2][3][4][5][6]. However, our study revealed no significant correlation between histology and N2 disease.…”

Section: Commentcontrasting

confidence: 83%

“…In our study, the overall rate of unsuspected N2 disease was 17.6% (20 of 113), which was higher than reported [2][3][4][5][6]. In previous studies, the overall rate of N2 disease that could not be detected by PET or PET/CT varied from 4.8% to 15.3%.…”

Section: Commentcontrasting

confidence: 76%

“…However, PET scanning is less sensitive for lymph nodes with diameters between 7 mm and 10 mm, and most of the invasive technologies (mediastinoscopy, endobronchial ultrasonography [EBUS], endoscopic ultrasonography [EUS]) have been able to identify unsuspected mediastinal metastases in patients with normal-sized lymph nodes without PET scanning activity [1,2]. In previous studies, the overall rate of unsuspected N2 disease that could not be detected by PET or PET/CT was reported to vary from 4.8% to 15.3% [2][3][4][5][6], which caused us to undertake the present study.…”

mentioning

confidence: 98%

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Endobronchial Ultrasonography for Positron Emission Tomography and Computed Tomography–Negative Lymph Node Staging in Non-Small Cell Lung Cancer

Shingyoji

Nakajima

Matsuo

et al. 2014

The Annals of Thoracic Surgery

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Section: Commentcontrasting

confidence: 83%

Section: Commentcontrasting

confidence: 76%

mentioning

confidence: 98%

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Endobronchial Ultrasonography for Positron Emission Tomography and Computed Tomography–Negative Lymph Node Staging in Non-Small Cell Lung Cancer

Shingyoji

Nakajima

Matsuo

et al. 2014

The Annals of Thoracic Surgery

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“…1). The characteristics of the 56 studies was shown in Supporting Information Table 1 4–6, 14, 23–74. Among the included studies, 46 evaluated LN metastatic disease and 13 assessed extrathoracic metastatic disease.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic value of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography for the detection of metastases in non–small‐cell lung cancer patients

Zhang

et al. 2012

Intl Journal of Cancer

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In the recent years, fluorine 18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) has emerged as a new modality for staging non-small-cell lung cancer (NSCLC) patients. The aim of this meta-analysis was to assess the diagnostic value of 18 F-FDG PET/CT in detecting metastatic lesions in NSCLC patients. Meta-analysis methods were used to pool sensitivity, specificity, positive and negative likehood ratios, diagnostic odd ratios and to construct a summary receiver-operating characteristic curve. Data from included studies were pooled to compare the diagnostic accuracy between PET/CT and PET or CT alone in nodal staging. Totally, 56 studies involving 8,699 patients met the inclusion criteria. Lung cancer is the leading cause of tumor-related deaths worldwide, and non-small-cell lung cancer (NSCLC) accounts for about 80% of all lung cancers. 1 The current criteria for staging NSCLC is based on the TNM system, 2 which determines treatment options and predicts survival. 3 So, staging NSCLC is important, and accurate clinical methods are in great need. Various diagnostic methods have been used for staging NSCLC. [4][5][6][7] Computed tomography (CT) has been widely used to evaluate the nodal status of lung cancer based on the size or shape of the lymph nodes. 8 However, the sensitivity and the specificity were relatively low, because the lymph node size may not correlate with the presence of metastatic disease. 9 Based on the fact that malignant cells show higher rates of glycolysis than most surrounding normal structures, 10 fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been introduced and developed as an effective modality for tumor staging in a variety of cancers. 11 However, PET has relatively poor spatial resolution, thus limits its anatomical localization of lesions. 12 Mediastinoscopy, endobronchial and endoscopic ultrasound, and other surgical procedures are frequently used for thoracic nodal evaluation in lung cancer, but these techniques are invasive and cumbersome. 7,13 In the past recent years, 18 F-FDG PET/CT has emerged as a new modality for staging NSCLC patients. 4,14 The aim of this study was to evaluate the diagnostic accuracy of 18 F-FDG PET/CT in detecting metastases in NSCLC patients. Material and Methods Selection criteriaSelection criteria were given as follows: (1) 18 F-FDG PET/CT was used for the evaluation of lymph node (LN) metastases or extrapulmonary metastases in NSCLC; (2) histologic assessment should be applied as reference standard for LN metastases; for studies evaluated extrathoracic metastases, other reference standards such as imaging modality, radiological and clinical follow-up were also applied; (3) absolute numbers of true-positive (TP), false-positive (FP), true-

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“…As they have commented in their manuscript, following the recommendations of the European Society of Thoracic Surgeons (ESTS) guidelines for preoperative mediastinal nodal staging, high negative predictive values (91-95%) and low rates of unsuspected pathologic (p) N2 disease (5.1-5.5%) are achieved (1,2). The majority of patients with unsuspected pN2 have single station involvement and better survival compared with the global cohort of pN2 (2).…”

mentioning

confidence: 99%

Rebuttal from Dr. Obiols and Dr. Call

Obiols

Call

2016

Transl. Lung Cancer Res.

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The validity of preoperative lymph node staging guidelines of European Society of Thoracic Surgeons in non-small-cell lung cancer patients☆

Abstract: The preoperative LNSGs for NSCLC proposed by the ESTS are effective.

Cited by 19 publications

References 15 publications

Endobronchial Ultrasonography for Positron Emission Tomography and Computed Tomography–Negative Lymph Node Staging in Non-Small Cell Lung Cancer

Endobronchial Ultrasonography for Positron Emission Tomography and Computed Tomography–Negative Lymph Node Staging in Non-Small Cell Lung Cancer

Diagnostic value of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography for the detection of metastases in non–small‐cell lung cancer patients

Rebuttal from Dr. Obiols and Dr. Call

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