EBUS-TBNA in mediastinal staging of non-small cell lung cancer: comparison with pathological staging.

Autor:	Braga S; Serviço de Pneumologia, Hospital Sousa Martins - Unidade Local de Saúde da Guarda E.P.E., Guarda, Portugal., Costa R; Serviço de Cirurgia Torácica, Centro Hospitalar Universitário de São João E.P.E., Porto, Portugal., Magalhães A; Serviço de Pneumologia, Centro Hospitalar Universitário de São João E.P.E., Porto, Portugal., Fernandes G; Serviço de Pneumologia, Centro Hospitalar Universitário de São João E.P.E., Porto, Portugal.
Jazyk:	angličtina
Zdroj:	Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia [J Bras Pneumol] 2024 Aug 19; Vol. 50 (3), pp. e20230353. Date of Electronic Publication: 2024 Aug 19 (Print Publication: 2024).
DOI:	10.36416/1806-3756/e20230353
Abstrakt:	Objective: Although EBUS-TBNA combined with EUS-FNA or EUS-B-FNA stands as the primary approach for mediastinal staging in lung cancer, guidelines recommend mediastinoscopy confirmation if a lymph node identified on chest CT or showing increased PET scan uptake yields negativity on these techniques. This study aimed to assess the staging precision of EBUS/EUS. Methods: We conducted a retrospective study comparing the clinical staging of non-small cell lung cancer patients undergoing EBUS/EUS with their post-surgery pathological staging. We analyzed the influence of histology, location, tumor size, and the time lapse between EBUS and surgery. Patients with N0/N1 staging on EBUS/EUS, undergoing surgery, and with at least one station approached in both procedures were selected. Post-surgery, patients were categorized into N0/N1 and N2 groups. Results: Among the included patients (n = 47), pathological upstaging to N2 occurred in 6 (12.8%). Of these, 4 (66.7%) had a single N2 station, and 2 (33.3%) had multiple N2 stations. The adenopathy most frequently associated with upstaging was station 7. None of the analyzed variables demonstrated a statistically significant difference in the occurrence of upstaging. PET scan indicated increased uptake in only one of these adenopathies, and only one was visualized on chest CT. Conclusions: Upstaging proved independent of the studied variables, and only 2 patients with negative EBUS/EUS would warrant referral for mediastinoscopy. Exploring other noninvasive methods with even greater sensitivity for detecting micrometastatic lymph node disease is crucial.
Databáze:	MEDLINE
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