EBUS-TBNA is highly accurate in staging patients with non-smaIl ceIl lung cancer (NSCLC) who have enlarged mediastinal lymph nodes on CT scan. In this study we report the accuracy and yield of EBUS-TBNA in staging patients without enlarged mediastinal lymph nodes by CT.
Patients with NSCLC and CT scan showing no enlarged mediastinal lymph nodes (> 1 cm for aIl nodes) in the mediastinum underwent bronchoscopy with EBUS. TBNA was performed on identifiable lymph nodes in the locations 2r, 2l, 3, 4r, 4l, 7, 10r, 10l, 11r and 11l. All patients underwent subsequent surgical staging and the results were compared to operative findings.
100 patients (68 male, 32 female, mean age 58.9 y.) were evaluated, 119 lymphnodes punctured. EBUS-TBNA detected malignant mediastinal lymph nodes in 22 of 100 patients, all surgical confirmed. The mean diameter of the punctured lymph nodes was 8.1 mm (SD±0,7). The sensitivity of EBUS-TBNA for mediastinal disease was 92.3 %, the specificity was 100 % and the negative predictive value 96.3 %.No complications were seen.
EBUS TBNA can detect advanced mediastinal disease and avoid unnecessary surgical exploration in 1 of 5 patients who have no evidence of mediastinal disease on CT scan. This data suggests that all potentiaIly operable patients with clinically nonmetastatic NSCLC may benefit from presurgical EBUS-TBNA staging.
This data suggests that all potentiaIly operable patients with clinically nonmetastatic NSCLC may benefit from presurgical EBUS-TBNA staging.
Felix Herth, None.