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Less Invasive Lung Cancer Staging Looks Promising
Date:11/23/2010

eath rates for any cause by 7 percent.

Given that lung cancer is the nation's leading cancer killer, this new study is another piece of good news.

For the current study, Annema and colleagues compared less invasive staging of lung cancer using endosonography, which combined transesophageal and endobronchial ultrasound, with surgery in 241 lung cancer patients.

These patients underwent either surgery or endosonography followed by surgery when no nodal metastases were found at endosonography.

Of the 241 patients, 118 had surgical staging and 123 endosonography. Of those who received endosonography, 65 also underwent surgery, the researchers noted.

Among the patients whose cancer had spread beyond the lung, 41 (35 percent) were identified by surgery, while 56 (46 percent) were spotted by endosonography and 62 (50 percent) were pinpointed after endosonography followed by surgery.

There were 21 unnecessary surgeries in the surgical group (18 percent), compared with nine (7 percent) in the endosonography group, Annema's team found.

In addition, there was no difference in the rate of complications between the groups, they note.

"We expect current guidelines will be changed," Annema said.

Commenting on the study, Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said that, "if this can be borne out in larger trials, going to thoracotomy to stage patients may not be necessary."

If you can spare someone with extensive disease a thoracotomy with the chances of complications and extensive healing time, treatment with chemotherapy and radiation can start much sooner, he said.

"If you do an unnecessary thoracotomy, you are really delaying treatment," Horovitz said. Before this new method could become standard care, doctors would need to be trained in the technique, he added.

Another expert agrees this new technique could be a better option than a thoracotomy for diagnosing
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