Akademik Veri Yönetim Sistemi
THORACIC AND CARDIOVASCULAR SURGEON, cilt.50, sa.3, ss.174-177, 2002 (SCI-Expanded)
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.