Staging of Non-Small Cell Lung Cancer Mediastinoscopy or Bronchoscopic Needle Aspiration?Pro: Bronchoscopic Needle Aspiration

摘要

Surgical resection of localized disease affords the best hope of survival for patients with non-small cell lung cancer (NSCC). Unfortunately, no more than 20% of patients with NSCC qualify for resection.Careful determination of tumor spread is needed to determine treatment options and to provide prognosis. Initial assessment includes a thorough history and physical examination, routine laboratory tests, and imaging with a plain chest radiograph and chest computed tomography (CT). In addition, evaluation of mediastinal involvement is needed before surgical resection because as many as 45% of patients during thoracotomy will have nodal involvement, making them surgically unresectable.Proper staging is imperative to spare the patient the associated risks, costs, and discomfort of unnecessary surgery. Chest CT alone is insufficient because it especially has a poor specificity; histologic evaluation is needed.