Subscribe to RSS
DOI: 10.1055/s-0031-1299577
Superiority of Video-Assisted to Standard Mediastinoscopy in Non-Small-Cell Lung Cancer Staging
Publication History
19 July 2011
05 October 2011
Publication Date:
12 March 2012 (online)
![](https://www.thieme-connect.de/media/thoracic/201208/lookinside/thumbnails/10.1055-s-0031-1299577-1.jpg)
Abstract
Background We compared the efficiency of videomediastinoscopy (VM) and standard mediastinoscopy (SM) in detecting mediastinal lymph node (MLN) metastasis in non-small-cell lung cancer (NSCLC) patients.
Methods By SM method a surgeon sampled bilateral paratracheal and subcarinal lymph node stations and then by VM method, another surgeon resampled all lymph node stations once more through the same incision in the same operative setting. Results of the pathologic examinations of two methods were compared.
Results Twenty-seven consecutive mediastinoscopies were included. The numbers of nodal stations biopsied in SM and VM were 97 and 103, respectively. Lymph node metastasis was found in six patients with SM and nine patients with VM. Lymph node dissection by thoracotomy revealed metastases, which were not found by mediastinoscopy, in two patients. Our study showed an accuracy of 92.3% for VM versus 80.7% for SM and corresponding negative predictive values of 88.2% and 75%, respectively (p = 0.002; [Fig. 1]).
Conclusion This study showed that VM is superior to SM in detecting MLN metastasis in patients with NSCLC.
Notes
This study was presented at the 18th European Conference on General Thoracic Surgery organized by European Society of Thoracic Surgeons (ESTS), Valladolid, Spain, May 30 to June 2, 2010.
-
References
- 1 Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest 1997; 111 (6) 1718-1723
- 2 Johnston MR. Invasive staging of the mediastinum. World J Surg 1993; 17 (6) 700-704
- 3 Shields TW. Lung cancer: diagnosis and staging of lung cancer. In: Shields TW, , ed. General Thoracic Surgery. London: William & Wilkins; 2006: 98
- 4 Goldstraw P, Crowley J, Chansky K , et al; International Association for the Study of Lung Cancer International Staging Committee; Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumors. J Thorac Oncol 2007; 2 (8) 706-714
- 5 National Cancer Institute Surveillance. Surveillance, epidemiology and end results (SEER). Available at: http://seer.cancer.gov/ . Accessed May 2, 2010
- 6 Freixinet Gilart J, García PG, de Castro FR, Suárez PR, Rodríguez NS, de Ugarte AV. Extended cervical mediastinoscopy in the staging of bronchogenic carcinoma. Ann Thorac Surg 2000; 70 (5) 1641-1643
- 7 Venissac N, Alifano M, Mouroux J. Video-assisted mediastinoscopy: experience from 240 consecutive cases. Ann Thorac Surg 2003; 76 (1) 208-212
- 8 Pop D, Venissac N, Leo F, Mouroux J. Video-assisted mediastinoscopy: a useful technique for paratracheal mesothelial cysts. J Thorac Cardiovasc Surg 2005; 129 (3) 690-691
- 9 Leschber G, Sperling D, Klemm W, Merk J. Does video-mediastinoscopy improve the results of conventional mediastinoscopy?. Eur J Cardiothorac Surg 2008; 33 (2) 289-293
- 10 Witte B, Wolf M, Huertgen M, Toomes H. Video-assisted mediastinoscopic surgery: clinical feasibility and accuracy of mediastinal lymph node staging. Ann Thorac Surg 2006; 82 (5) 1821-1827
- 11 De Leyn P, Lardinois D, Van Schil PE , et al. ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg 2007; 32 (1) 1-8
- 12 Yasufuku K, Chiyo M, Koh E , et al. Endobronchial ultrasound guided transbronchial needle aspiration for staging of lung cancer. Lung Cancer 2005; 50 (3) 347-354
- 13 Karfis EA, Roustanis E, Beis J, Kakadellis J. Video-assisted cervical mediastinoscopy: our seven-year experience. Interact Cardiovasc Thorac Surg 2008; 7 (6) 1015-1018