Posts Tagged ‘endosonography’

Staging Lung Cancer Using Less Invasive Method Shows Promise

Wednesday, December 1st, 2010

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In a study reported in the November 24 issue of the Journal of the American Medical Association (see the reference below) researchers concluded that when using two interventions to determine the stage of suspected non-small cell lung cancer (NSCLC) the less invasive may be more effective and save the patient unnecessary surgery.

In the study the researchers compared the two recommended lung cancer staging strategies that are endosonography, untrasound using a fiberoptic endoscope, considered the less invasive and
surgery. Currently, endosonography may be followed by surgical staging if no nodal metastases are found. Surgical staging alone has limitations and mit is believed may result in unnecessary surgery.

Interventions in the study included either surgical staging or endosonography followed by surgical staging if no nodal metastases were found and thoracotomy (surgical procedure) with lymph node dissection when there was no evidence of mediastinal (space near the lungs in the thoracic cavity) spread of the tumor.

Two hundred forty one patients with suspected NSCLC in whom mediastinal staging was indicated were randomized into the two group during the period February 2007 to April 2009. Of these, 118 were in the surgical staging group, and 123 in the endosonography group. Of the later group 65 also underwent surgical staging. “Nodal metastases were found in 41 patients (35%) by surgical staging vs 56 patients by endosonography (46%) and in 62 patients (50%) by endosonography followed by surgical staging. This corresponded to sensitivity of 79% (41/52) vs 85% (56/66) and 94% (62/66).” Unnecessary thoracotomies were performed on 21 patients (18%) in the mediastinoscopy group vs 9 (7%) in the endosonography group.

The authors concluded that among suspect NSCLC patients a staging strategy combining endosonography and surgical staging resulted in greater sensitivity for mediastinal nodal metastases and fewer unnecessary thoracotomies than using surgical strategies alone.
See the full study below:
http://jama.ama-assn.org/cgi/content/full/304/20/2245