Mediastinal staging of lung cancer: Novel concepts

Kurt G. Tournoy, Steven M. Keller, Jouke T. Annema

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Clinical TNM staging is the standard method used to decide treatment for patients with non-small-cell lung cancer. Although integrated fluorodeoxyglucose (FDG) PET CT increases the accuracy of staging, it only guides direct tissue sampling. Histological assessment of mediastinal lymph nodes has traditionally been done with mediastinoscopy, a surgical procedure. Endobronchial and oesophageal ultrasound-guided lymph node sampling have been assessed as additions or alternatives to mediastinoscopy. We review endosonography and surgical staging, and show that both have a place in the mediastinal staging of lung cancer. We conclude that mediastinal tissue staging should preferentially start with a complete endosonographic assessment. A surgical mediastinoscopy should be reserved for those in whom the endosonography result is negative. Further refinement of this recommendation is likely in the near future because data suggest that the confirmatory mediastinoscopy is particularly useful for patients with enlarged or FDG-avid lymph nodes.

Original languageEnglish (US)
JournalThe Lancet Oncology
Volume13
Issue number5
DOIs
StatePublished - May 2012

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Mediastinoscopy
Lung Neoplasms
Endosonography
Lymph Nodes
Neoplasm Staging
Non-Small Cell Lung Carcinoma

ASJC Scopus subject areas

  • Oncology

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Mediastinal staging of lung cancer : Novel concepts. / Tournoy, Kurt G.; Keller, Steven M.; Annema, Jouke T.

In: The Lancet Oncology, Vol. 13, No. 5, 05.2012.

Research output: Contribution to journalArticle

Tournoy, Kurt G. ; Keller, Steven M. ; Annema, Jouke T. / Mediastinal staging of lung cancer : Novel concepts. In: The Lancet Oncology. 2012 ; Vol. 13, No. 5.
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