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News Americas

According to the World Health Organization, lung cancer is responsible for the most cancer deaths each year compared with liver, stomach, colorectal and breast cancers. (Photograph: muratart/Shutterstock)
Sep 16, 2014 | News Americas

Endoscopic biopsy could replace mediastinal surgery for staging lung cancer

by Surgical Tribune

MONTREAL, Canada: Endoscopic biopsy of lymph nodes between the two lungs (mediastinum) is a sensitive and accurate technique that can replace mediastinal surgery for staging lung cancer in patients with potentially resectable tumors, Canadian researchers have found. Moreover, the study showed that it is not necessary to perform surgery to confirm negative results obtained through the endoscopy approach during the preoperative evaluation of patients with this type of cancer.

This discovery holds many advantages for both patients and the health care system.

Endoscopic biopsy of the lymph nodes is a minimally invasive, nonsurgical intervention that has recently been applied to the staging of lung cancer. The study conducted under Dr. Moishe Liberman, a researcher at the Centre Hospitalier de l'Université de Montréal Research Centre and associate professor at the Université de Montréal, involved 166 patients with confirmed or suspected nonsmall cell lung cancer, and was designed to compare the new approach to surgical staging under general anesthesia, as prescribed in current guidelines for this type of cancer. The findings show that the endoscopy approach not only is sensitive and accurate, but also leads to improved staging compared with surgical staging owing to its ability to biopsy lymph nodes and metastases not attainable with surgical techniques.

All patients underwent endobronchial ultrasound (EBUS), endoscopic ultrasound (EUS) and surgical mediastinal staging (SMS) during a single procedure. Each subject served as his or her own control. The results of the EBUS, EUS and combined EBUS/EUS were compared to SMS (gold standard) results and, in patients with negative lymph node staging, to lymph node sampling at pulmonary resection.

The study, titled "Endosonographic Mediastinal Lymph Node Staging of Lung Cancer," was published in the August issue of the CHEST Journal , the official publication of the American College of Chest Physicians.

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