The value of mediastinoscopy in preoperative evaluation of mediastinal involvement in non-small-cell lung cancer patients with clinical NO disease


Gürses A., TURNA A., Bedirhan M., Özalp T., Kocatürk C., DEMİR A., ...More

THORACIC AND CARDIOVASCULAR SURGEON, vol.50, no.3, pp.174-177, 2002 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 50 Issue: 3
  • Publication Date: 2002
  • Doi Number: 10.1055/s-2002-32416
  • Journal Name: THORACIC AND CARDIOVASCULAR SURGEON
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.174-177
  • Istanbul University Affiliated: No

Abstract

Background: The efficacy of mediastinal lymph node examination using cervical mediastinoscopy in operable non-small cell lung cancer patients without radiological nodal involvement on computerized tomography (CT) has been elusive. Methods: The value of mediastinoscopy as a staging modality for assessing the mediastinal lymph node status was evaluated in 79 patients with presumed resectable non-small-cell lung cancer (NSCLC) with mediastinal nodes smaller than I cm (NO) form the CT scan. Sixty-one patients who did not have nodal involvement at mediastinoscopy and had complete medical records underwent complete resection. Results: Negative predictive value (NPV) of the CT scan according to mediastinoscopy was 92.4%. Histopathological examination of the surgical specimen showed the NPV of mediastinoscopy to be 93.4%. Only 4 patients (3 patients with N2, 1 patient with N3 disease) were not correctly staged using CT scanning and mediastinoscopy. According to the pathological examination, the NPV of CT was found to be lower (76.5%) in patients with adenocarcinoma, but the difference was not statistically significant (p > 0.128) Conclusion: Although the likelihood Of surgical-pathological N2 is slightly higher in patients with adenocarcinoma, radiological examination of patients with cNO NSCLC disease can be as accurate as mediastinoscopy in appropriately staging mediastinal lymph node involvement.