| Autor: |
Rodriguez GR; Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA., Trachiotis GD; Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA.; Division of Cardiothoracic Surgery and Heart Center, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, USA., Mullenix PS; Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA., Antevil JL; Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA.; Division of Cardiothoracic Surgery and Heart Center, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, USA. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of laparoendoscopic & advanced surgical techniques. Part A [J Laparoendosc Adv Surg Tech A] 2024 Sep; Vol. 34 (9), pp. 773-785. Date of Electronic Publication: 2024 May 10. |
| DOI: |
10.1089/lap.2024.0138 |
| Abstrakt: |
Background: Lung cancer remains the leading cause of cancer deaths in the United States despite declining incidence and improved outcomes because of advancements in early detection and development of novel therapies. Accurate mediastinal lymph node staging is crucial for determining prognosis and guiding treatment decisions, particularly for non-small cell lung cancer (NSCLC). Materials and Methods: A systematic search of PubMed was conducted to identify English language articles published between January 2010 and January 2024 focusing on preoperative lymph node staging in adults with NSCLC. Case series, observational studies, randomized trials, guidelines, narrative reviews, systematic reviews, and meta-analyses were included. Results: Various imaging modalities, surgical and nonsurgical procedures for mediastinal lymph node staging were reviewed, including positron emission tomography with computed tomography, cervical mediastinoscopy, video-assisted cervical mediastinoscopy, anterior mediastinotomy, video-assisted thoracoscopy, endobronchial ultrasound-guided fine needle aspiration (EBUS-FNA), transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), and computed tomography-guided percutaneous lymph node biopsy. EBUS-FNA emerged as the preferred initial staging procedure because of its high sensitivity and low complication rate. Combining it with other procedures or confirmatory testing may be helpful in determining appropriate treatment. Conclusions: Although cervical mediastinoscopy remains a valuable confirmatory procedure in select cases, its role as a first-line staging modality is diminishing with the widespread adoption of EBUS-FNA and EUS-FNA. The combination of EBUS-FNA and EUS-FNA allows access to nearly all mediastinal lymph node stations with high diagnostic accuracy. Future research may further refine the selection criteria for invasive mediastinal staging procedures, ultimately optimizing patient outcomes in the management of NSCLC. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
|
