Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer.
Purpose: To investigate the sensitivity and accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for restaging the mediastinum after induction chemotherapy in patients with non-small-cell lung cancer (NSCLC). Patients and Methods: One hundred twenty-four consecuti...
| Publicado en: | Journal of Clinical Oncology Vol. 26; no. 20; pp. 3346 - 3351 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
American Society of Clinical Oncology
7/10/2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105798413&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105798413 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0732183X 20D jtl: Journal of Clinical Oncology issn: 0732183X maglogo: N pubinfo: dt: 7/10/2008 vid: 26 iid: 20 pid: 26892 pub: American Society of Clinical Oncology place: Alexandria, Virginia artinfo: ui: 105798413 105798413 NLM18519953 2009977647 10.1200/JCO.2007.14.9229 NLM18519953 105798413 ppf: 3346 ppct: 5 formats: tig: atl: Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer. aug: au: Herth FJ Annema JT Eberhardt R Yasufuku K Ernst A Krasnik M Rintoul RC Herth, Felix J F Annema, Jouke T Eberhardt, Ralf Yasufuku, Kazuhiro Ernst, Armin Krasnik, Mark Rintoul, Robert C affil: Department of Internal Medicine, Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Amalienstr 5, D-69126, Heidelberg, Germany sug: subj: Biopsy, Needle Methods Carcinoma, Non-Small-Cell Lung Ultrasonography Carcinoma, Non-Small-Cell Lung Lung Neoplasms Ultrasonography Lymph Nodes Pathology Mediastinal Neoplasms Adult Aged Aged, 80 and Over Bronchoscopy Methods Carcinoma, Non-Small-Cell Lung Mortality Endosonography Methods Female Lung Neoplasms Mortality Lung Neoplasms Pathology Male Mediastinal Neoplasms Mortality Mediastinal Neoplasms Ultrasonography Middle Age Neoplasm Invasiveness Pathology Neoplasm Staging Predictive Value of Tests Prognosis Prospective Studies Retrospective Design Risk Assessment Sensitivity and Specificity Survival Analysis Thoracoscopy Methods Human Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Purpose: To investigate the sensitivity and accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for restaging the mediastinum after induction chemotherapy in patients with non-small-cell lung cancer (NSCLC). Patients and Methods: One hundred twenty-four consecutive patients with tissue-proven stage IIIA-N2 disease who were treated with induction chemotherapy and who had undergone mediastinal restaging by EBUS-TBNA were reviewed. On the basis of computed tomography, 58 patients were classified as having stable disease and 66 were judged to have had a partial response. All patients subsequently underwent thoracotomy with attempted curative resection and a lymph node dissection regardless of EBUS-TBNA findings. Results: Persistent nodal metastases were detected by using EBUS-TBNA in 89 patients (72%). Of the 35 patients in whom no metastases were assessed by EBUS-TBNA, 28 were found to have residual stage IIIA-N2 disease at thoracotomy. The majority (91%) of these false negative results were due to nodal sampling error rather than detection error. Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EBUS-TBNA for mediastinal restaging after induction chemotherapy were 76%, 100%, 100%, 20%, and 77%, respectively. Conclusion: EBUS-TBNA is a sensitive, specific, accurate, and minimally invasive test for mediastinal restaging of patients with NSCLC. However, because of the low negative predictive value, tumor-negative findings should be confirmed by surgical staging before thoracotomy. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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