Mediastinal staging by thoracic surgeons: are we close to a paradigm shift?

[摘要] Mediastinal lymph node assessment plays a pivotal role in staging patients with potentially resectable non-small cell lung cancer (NSCLC). Current American (1) and European (2) clinical practice guidelines for preoperative mediastinal lymph node staging recommend minimally invasive procedures, such as endobronchial ultrasonography (EBUS) and endoscopic ultrasonography (EUS), as the method of choice. If E(B)US is negative, but with suspected N2 disease on positron emission tomography/computed tomography (PET/CT), confirmatory surgical videoassisted mediastinoscopy or video-assisted mediastinoscopic lymphadenectomy (VAMLA) is advised. While multiple reports exist on the use and diagnostic accuracy of E(B)US compared to mediastinoscopy as the gold standard (3-5), limited data is available on training and experience of both techniques by thoracic surgeons.

[学科分类] 呼吸医学

[关键词] Mediastinal staging;endobronchial ultrasonography (EBUS);mediastinoscopy