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EUS-FNA in the preoperative staging of non-small cell lung cancer
Lung Cancer, 09/22/09

Talbebian M et al. – Routine use of EUS-FNA in unselected patients with NSCLC reduces the need for surgical staging procedures in nearly half of patients. Additional surgical staging in patients without nodal metastases at EUS-FNA reduces the false negative EUS-FNA findings considerably regardless of the location of the primary lung tumor.

Methods

152 consecutive operable patients with proven or suspected NSCLC who underwent EUS-FNA were retrospectively analyzed. In the absence of mediastinal metastases, mediastinoscopy and/or thoracotomy with lymph node dissection was performed.

Results

The prevalence of mediastinal metastases was 49%
Sensitivity, negative predictive value (NPV) and accuracy of EUS-FNA for N2/N3 disease were 74%, 73% and 85% respectively, whereas these values for the combined staging of EUS-FNA and mediastinoscopy were 92%, 85% and 95%
Additional surgical staging in patients staged N0 at EUS-FNA reduces the false negative EUS-findings by 55%
The NPV of EUS-FNA for left-sided tumors was 68%
EUS-FNA prevented surgical staging procedures in 60 of 152 patients (39%)
No major complications occurred during EUS-FNA

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BMC Cancer, 10/09/09 Relevance Score: 70%

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EurekAlert, 10/08/09 Relevance Score: 70%