The validity of preoperative lymph node staging guidelines of European Society of Thoracic Surgeons in non-small-cell lung cancer patients §
Mehmet Zeki Gunluoglu,Hüseyin Melek,Baris Medetoglu,Adalet Demir,Hasan Volkan Kara,Seyyit Ibrahim Dincer +5 more
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The preoperative LNSGs for NSCLC proposed by the ESTS are effective and the sensitivity, specificity, and positive and negative predictive values of the guidelines were calculated as 84%, 100%, 100% and 94%, respectively.Abstract:
Objective: The European Society of Thoracic Surgeons (ESTS) has proposed preoperative lymph-node staging guidelines (LNSGs) for non-smallcell lung cancer (NSCLC) based on the introduction of new staging modalities into clinical practice. The validity of these guidelines was assessed. Methods: Among the patients (n = 185) with histologically confirmed NSCLC diagnosed between 2007 and 2009, who were suitable for thoracotomy, the 168 who underwent computed tomography (CT) of the chest and CT-integrated positron emission tomography (PET-CT) were included in the study. The preoperative mediastinal stage was confirmed by mediastinoscopy in all patients. A thoracotomy was done for mediastinoscopy-negative patients. The mediastinal staging results were adapted to the ESTS-LNSG (direct thoracotomy for T1—2 N0 tumour according to CT and PET-CT and invasive staging for others) and the validity of the guidelines was tested. Results: In this series, the overall mediastinal lymph-node metastasis (MLNM) prevalence was 29.2%. If the guidelines had been applied, thoracotomy without invasive mediastinal stagingwould have been done in only11 (6.5%) patients, and no MLNMwould have been detected.Mediastinoscopy would have been performed in 157 patients and MLNM would have been found in 41 (26%). In the 116 mediastinoscopy-negative patients, MLNM would have been detected after thoracotomy in an additional eight patients. Thus, the sensitivity, specificity, and positive and negative predictive values of the guidelines were calculated as 84%, 100%, 100% and 94%, respectively. Conclusions: The preoperative LNSGs for NSCLC proposed by the ESTS are effective. # 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.read more
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Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer.
Paul De Leyn,Christophe Dooms,Jarosław Kużdżał,Didier Lardinois,Bernward Passlick,Ramón Rami-Porta,Akif Turna,Paul Van Schil,Frederico Venuta,David A. Waller,Walter Weder,Marcin Zieliński +11 more
TL;DR: A revision of the ESTS guidelines was needed because more evidence of the different mediastinal staging technique has become available and both endoscopic techniques and surgical procedures are available, but their negative predictive value is lower compared with the results obtained in baseline staging.
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PET-CT for assessing mediastinal lymph node involvement in patients with suspected resectable non-small cell lung cancer.
Mia Schmidt-Hansen,David R Baldwin,Elise Hasler,Javier Zamora,Víctor Abraira,Marta Roqué i Figuls +5 more
TL;DR: The diagnostic accuracy of integrated PET-CT for mediastinal staging of patients with suspected or confirmed NSCLC that is potentially suitable for treatment with curative intent is determined.
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Three-way Comparison of Whole-Body MR, Coregistered Whole-Body FDG PET/MR, and Integrated Whole-Body FDG PET/CT Imaging: TNM and Stage Assessment Capability for Non–Small Cell Lung Cancer Patients
Yoshiharu Ohno,Hisanobu Koyama,Takeshi Yoshikawa,Daisuke Takenaka,Shinichiro Seki,Masao Yui,Hitoshi Yamagata,Kota Aoyagi,Sumiaki Matsumoto,Kazuro Sugimura +9 more
TL;DR: Accuracies of whole-body MR imaging andPET/MR imaging with SI assessment are superior to PET/MR without SI assessment and PET/CT for identification of TNM factor, clinical stage, and operability evaluation of NSCLC patients.
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Michael K. Gould,Ware G. Kuschner,Chara E. Rydzak,Courtney C. Maclean,Anita N Demas,Hidenobu Shigemitsu,Jo Kay Chan,Douglas K Owens +7 more
TL;DR: A synthesis of 39 studies found that FDG-PET was more accurate than CT for identifying lymph node involvement and CT was more sensitive but less specific in patients with lymph node enlargement on CT.
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ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer
Paul De Leyn,Didier Lardinois,Paul Van Schil,Ramón Rami-Porta,Bernward Passlick,Marcin Zieliński,David A. Waller,T. Lerut,Walter Weder +8 more
TL;DR: For restaging, invasive techniques providing cyto-histological information are advisable despite the encouraging results supported with the use of PET/CT imaging, both endoscopic techniques and surgical procedures are available.