| Title | Impact of Pre-Operative Endoscopic Ultrasound on Non-Small Cell Lung Cancer Staging. | | Author(s) | Sawhney MS, Bakman Y, Holmstrom AM, Nelson DB, Lederle FA, Kelly RF | | Institution | Section of Gastroenterology [MSS, DBN], and Center for Epidemiological and Clinical Research [MSS, FAL], Minneapolis VA Medical Center; Department of Medicine, [MSS, YB, DBN, FAL] and Section of Cardio-thoracic Surgery, University of Minnesota [AMH, RFK]. | | Source | Chest 2007 Jun 15. | | Abstract | Aim To determine if the addition of pre-operative EUS to non-small cell lung cancer staging can reduce the proportion of patients in whom malignant mediastinal-lymph-nodes [inoperable disease] are discovered at surgery. Methods All patients with lung cancer who underwent a mediastinoscopy or thoracotomy for cancer diagnosis, staging, or treatment from 1999 to 2005 were identified. Patients that had undergone pre-operative EUS were designated as the EUS group. The control group was composed of similar patients who had not undergone pre-operative EUS, and were frequency-matched to those in the EUS group in a 3:1 ratio by pre-operative cancer stage. The proportion of patients in whom malignant mediastinal-lymph-nodes were diagnosed at surgery was the primary outcome. Results Forty-four patients, with average age 67.8years met criteria for EUS group, and 132 patients, with average age 67.4years, were selected as controls. Overall, in the EUS group, 3/44 patients [6.8%] were found to have malignant mediastinal-lymph-nodes at surgery, compared with 41/132 patients [31.1%] in the control group [p=0.003]. In patients undergoing thoracotomy for cancer resection, 3% in the EUS group, compared with 20% in the control group were found to have malignant mediastinal-lymph-nodes at surgery [p=0.01]. There was also a trend towards lower yield of mediastinoscopy done for cancer diagnosis or staging in the EUS group [p=0.08]. Conclusions Pre-operative EUS in lung cancer patients may reduce unnecessary surgery at which advanced inoperable disease is discovered. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 17573497 |
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