Mediastinal staging procedures in non-small cell lung cancer.

摘要

Dr Annema and colleagues1 conducted a methodical evaluation of mediastinal staging methods in non-small cell lung cancer (NSCLC). This trial showed that endosonographic staging with transesophageal ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) could obviate the need for mediastinoscopy in almost half the patients. These procedures are less invasive and have far less morbidity than mediastinoscopy. A combined approach, with mediastinoscopy reserved for those patients with negative findings from EUS-FNA and EBUS-TBNA, also resulted in superior sensitivity and negative predictive value over mediastinoscopy alone.