Navigation Links
Less Invasive Way to Stage Lung Cancer Shows Promise

Needle aspiration procedures worked as well as standard, invasive method

TUESDAY, Feb. 5 (HealthDay News) -- Less invasive approaches for determining how far lung cancer has spread may be better than traditional, invasive procedures.

Although the finding, published in the Feb. 6 issue of the Journal of the American Medical Association, needs to be confirmed, it may point to a new era for people with lung cancer or suspected lung cancer.

"Currently, most patients in the U.S. who have lung cancers get a surgical procedure to determine if the cancer has spread to the lymph nodes," explained study author Dr. Michael Wallace, a professor of medicine at the Mayo Clinic College of Medicine in Jacksonville, Fla. "This study suggests that a less invasive set of procedures are highly accurate and less invasive than surgical procedures, and therefore might be an alternative."

Lung cancer is the number one cancer killer in the United States. While early detection is key, proper staging, which primarily involves determining if the malignancy has spread to the lymph nodes, is important for therapy and prognosis.

For people whose cancer is still confined to the lungs and certain lymph nodes, surgery is the recommended treatment. But the benefit of surgery is less clear for patients whose cancer has spread further.

"If the cancer has already spread to the lymph nodes in the middle of chest, you can't cure it [with surgery], so it's very important to know if it has spread to those lymph nodes," explained Norman Edelman, chief medical officer for the American Lung Association. "This so-called mediastinoscopy [which requires general anesthesia] is considered the gold standard although . . . there are some nodes that are hard to get this way."

"Could this replace mediastinoscopy? Yes, it could, but right now the doctors would have to make a judgment," added Edelman. "We don't have the absolute final answer, but it's promising."

Edelman pointed out, however, that the minimally invasive techniques described in this paper may not be available in many local hospitals.

Current noninvasive techniques such as computed tomography (CT) or positron emission tomography (PET) have high false-positive and false-negative results, respectively.

This study compared the accuracy of three different minimally invasive methods of staging and combinations thereof: traditional transbronchial needle aspiration (TBNA), endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA), and transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA).

"These procedures are endoscopic, meaning there's no cutting involved through the skin, and they're done as outpatients under twilight sedation," Wallace explained. "Individuals come in and go home on the same day. Essentially, there is no recovery other than just letting the sedation wear off."

A total of 138 patients with suspected lung cancer were involved; 30 percent had malignant lymph nodes.

EBUS-FNA was more sensitive (meaning it picked up more malignancies) than TBNA, detecting 69 percent of malignant lymph nodes versus 36 percent.

The combination of EBUS-FNA and EUS-FNA had 93 percent estimated sensitivity and a 97 percent negative predictive value (proportion of patients with negative results who are actually negative), compared with either method used alone.

The combination, which had both higher sensitivity and higher negative predictive value, may be a substitute for current, invasive techniques, the authors stated.

If mediastinoscopy had been done only when the combination results were negative, the more invasive surgical procedure would have been avoided in 28 percent of patients, the study showed.

If the combination had completely replaced mediastinoscopy, 97 percent would have been correctly labeled as negative.

"It is really focused on less invasive ways to stage the cancers as opposed to earlier detection methods, but it allows us to better select patients who will benefit from surgery to do it in a less invasive way and, importantly, to avoid surgical procedures in patients where the tumor has already spread who wouldn't benefit from the surgery," Wallace said.

Wallace reported that he had received research grants from different makers of equipment relevant to endoscopic ultrasound.

More information

The American Lung Association has more on lung cancer.

SOURCES: Michael B. Wallace, M.D., professor, medicine, Mayo Clinic College of Medicine, Jacksonville, Fla.; Norman Edelman, M.D., chief medical officer, American Lung Association; Feb. 6, 2008, Journal of the American Medical Association

Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Less invasive methods may provide accurate means to determine lung cancer stage
2. Researchers find less invasive, highly accurate methods
3. Noninvasive ways to assess liver disease
4. Minimally Invasive Surgery Fixes Aneurysms
5. Z-shaped incision enhances minimally invasive surgery
6. Z-shaped incision enhances minimally-invasive surgery
7. Xeloda(R), Taxotere(R) and Herceptin(R) Combination Study Suggests Clinical Benefit in Invasive Breast Cancer with Shortened Treatment Cycle
8. Awake the Movie Highlights the Need for Goldilocks Anesthesia, Says Dr. Barry L. Friedberg, Developer of Bispectral Index (BIS) Monitored Propofol Ketamine Sedation, Now Trademarked as Minimally Invasive Anesthesia (MIA)(R)
9. Biomarkers predict risk for invasive breast cancer years before the tumor develops
10. AUA releases new guidelines on non-muscle invasive bladder cancer
11. Non-Invasive Fat-Melting Procedures - Hype or Reality?
Post Your Comments:
Related Image:
Less Invasive Way to Stage Lung  Cancer Shows Promise
(Date:6/27/2016)... ... June 27, 2016 , ... TherapySites, ... its affiliation with Tennessee Counseling Association. This new relationship allows TherapySites ... Tennessee Counseling Association, adding exclusive benefits and promotional offers. , "TCA is extremely ...
(Date:6/26/2016)... ... ... Quality metrics are proliferating in cancer care, and are derived from many ... the beholder, according to experts who offered insights and commentary in the current issue ... the full issue, click here . , For the American Society of Clinical ...
(Date:6/26/2016)... ... 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is helping to ... app. The fitness app plans to fix the two major problems leading the fitness industry ... fits all type program , They don’t eliminate all the reasons people quit ...
(Date:6/25/2016)... ... ... Bruton Memorial Library on June 21 due to a possible lice infestation, as reported by ... lice: the parasite’s ability to live away from a human host, and to infest common ... the event that lice have simply gotten out of control. , As lice are a ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... ... athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures as ... City area —Johnson is one of the first doctors to perform the treatment. ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... NAMUR , Belgium , ...  (NYSE MKT: VNRX), today announced the appointment of ... Board of Directors as a Non-Executive Director, effective ... the Company,s Audit, Compensation and Nominations and Governance ... Board, Dr. Futcher will provide independent expertise and ...
(Date:6/23/2016)... , June 23, 2016  MedSource announced ... as its e-clinical software solution of choice.  This ... best possible value to their clients by offering ... The preferred relationship establishes nowEDC as the EDC ... for MedSource,s full-service clients.  "nowEDC has long been ...
(Date:6/23/2016)... 2016 Any dentist who has made an implant ... process. Many of them do not even offer this as ... high laboratory costs involved. And those who ARE able to ... a high cost that the majority of today,s patients would ... Parsa Zadeh , founder of Dental Evolutions Inc. and inventor ...
Breaking Medicine Technology: