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The Yield of Endoscopic Ultrasound in Lung Cancer Staging: Does Lymph Node Size Matter?  Kurt G. Tournoy, MD, Frédéric De Ryck, MD, Lieve Vanwalleghem,

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Presentation on theme: "The Yield of Endoscopic Ultrasound in Lung Cancer Staging: Does Lymph Node Size Matter?  Kurt G. Tournoy, MD, Frédéric De Ryck, MD, Lieve Vanwalleghem,"— Presentation transcript:

1 The Yield of Endoscopic Ultrasound in Lung Cancer Staging: Does Lymph Node Size Matter? 
Kurt G. Tournoy, MD, Frédéric De Ryck, MD, Lieve Vanwalleghem, MD, Marleen Praet, MD, Frank Vermassen, MD, Georges Van Maele, PhD, Jan P. van Meerbeeck, MD  Journal of Thoracic Oncology  Volume 3, Issue 3, Pages (March 2008) DOI: /JTO.0b013e cbb Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

2 FIGURE 1 Yield and impact of EUS-FNA in lung cancer patients. Patient flow chart. Patients were allocated to group A when no enlarged MLN were seen on the CT scan. Patients were allocated to group B when at least one enlarged (short axis at least 10 mm) MLN was seen on the CT scan. All patients underwent EUS-FNA and in case no malignancy was shown in the MLN, a referral for surgical mediastinal exploration followed (mainly cervical mediastinoscopy). The prevalence of N2/N3 is shown in the upper left corner of the cross-tables (p < group A versus B). Test characteristics including sensitivity and NPV do not differ between groups A and B. Avoided surgery for mediastinal exploration was statistically higher in group B (p < 0.001). MLN, mediastinal lymph nodes; Se, sensitivity; Sp, specificity; PPV, positive predictive value; NPV, negative predictive value. Values given as percent with (95% CI). Journal of Thoracic Oncology 2008 3, DOI: ( /JTO.0b013e cbb) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

3 FIGURE 2 EUS-FNA and corresponding surgico-pathologic verification. Left panel, EUS-FNA of MLN 4L (aorto-pulmonary window). The fine needle is placed into the center of the MLN. The cytology of the fine-needle aspiration was negative. Right panel, Surgico-pathologic verification by mediastinoscopy. The normal parenchyma of the MLN is characterized by lymphocytes (deep purple dots) and antraco-silicotic pigment in the macrophages (dark brown color). In the right upper corner (arrow), a discrete but clear solitary tumor islet is present, situated in the subcapsular sinusoidal space of the MLN (H&E staining; magnification 200×). Journal of Thoracic Oncology 2008 3, DOI: ( /JTO.0b013e cbb) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

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