Navigation Links
Less invasive methods may provide accurate means to determine lung cancer stage
Date:2/5/2008

An evaluation of several endoscopic biopsy methods suggests that a minimally invasive approach may accurately determine the stage of suspected lung cancer, according to a study in the February 6 issue of JAMA.

Lung cancer is the most common cancer-related cause of death in the United States. Determining the stage of the disease is a critical factor regarding therapy and prognosis, according to background information in the article.

Noninvasive staging with chest computed tomography (CT) or positron emission tomography (PET) is associated with high rates of false-positive and false-negative results, respectively. The American College of Chest Physicians recommends invasive staging with tissue confirmation of suspected metastatic mediastinal [center part of the thoracic cavity] lymph nodes. Mediastinoscopy or thoracoscopy [a surgical procedure that requires incisions] has been the diagnostic standard, but less invasive methods have emerged as potential alternatives, the authors write.

Such methods include blind transbronchial needle aspiration (TBNA), endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), and, more recently, endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA).

Michael B. Wallace, M.D., M.P.H., of Mayo Clinic, Jacksonville, Fla., and colleagues compared the diagnostic accuracy of these three methods (and their combinations). Among 138 patients with suspected lung cancer who met all study criteria, 42 (30 percent) had malignant lymph nodes.

The researchers found that EBUS-FNA had higher sensitivity than TBNA (69 percent vs. 36 percent), detecting 29 (vs. 15) of the 42 malignant lymph nodes. EUS plus EBUS had higher estimated sensitivity (93 percent [39/42]) than any of the other methods. Compared with either EUS-FNA or EBUS-FNA alone, the combination identified 10 more malignant lymph nodes, with sensitivity estimated to be 24 percent higher than either approach alone.

The percentage of malignant lymph nodes detected by each procedure (number malignant/total number sampled) was 15 percent for TBNA, 19.7 percent for EBUS-FNA, and 22 percent for EUS-FNA. EUS plus EBUS also had higher sensitivity for detecting lymph nodes in any mediastinal location and for patients without lymph node enlargement on chest CT.

If mediastinoscopy had been performed only when results from EUS plus EBUS were negative, this surgical procedure would have been avoided in 28 percent (39/138) of patients in this study. If EUS plus EBUS had been used to completely replace mediastinoscopy (100 percent of patients), 97 percent would have been correctly labeled as negative, the authors write.

If these data are confirmed by other studies, they thus suggest that EUS plus EBUS may be an alternative method for surgical staging of the mediastinum in patients with suspected lung cancer.


'/>"/>

Contact: Paul Scotti
904-953-0199
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Researchers find less invasive, highly accurate methods
2. Noninvasive ways to assess liver disease
3. Minimally Invasive Surgery Fixes Aneurysms
4. Z-shaped incision enhances minimally invasive surgery
5. Z-shaped incision enhances minimally-invasive surgery
6. Xeloda(R), Taxotere(R) and Herceptin(R) Combination Study Suggests Clinical Benefit in Invasive Breast Cancer with Shortened Treatment Cycle
7. 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)
8. Biomarkers predict risk for invasive breast cancer years before the tumor develops
9. AUA releases new guidelines on non-muscle invasive bladder cancer
10. Non-Invasive Fat-Melting Procedures - Hype or Reality?
11. ArthroCare Releases New SpineWand(R) for Less Invasive Spinal Surgeries
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:9/22/2017)... ... September 22, 2017 , ... ... produced by Native Remedies that helps promote pancreatic health and regulate blood ... However, some prescription-based approaches can have negative side effects, and with the changes ...
(Date:9/22/2017)... ... ... “Fruit of the Spirit: “Love””: a delightful adventure of two friends ... of the Spirit: “Love”” is the creation of published author, Halimah Jones, who was ... Halimah is an avid writer, her inspiration for “Fruit of the Spirit: “Love”” blossomed ...
(Date:9/22/2017)... ... September 22, 2017 , ... Global ... diseases through research, education and awareness, today announced the appointment of Timothy J. ... microbiologist, Dr. Sellati has more than 20 years of research experience with Lyme ...
(Date:9/21/2017)... ... , ... SABRE is raising awareness about personal safety with a Chicago Transit ... , The Chicago, Illinois, based self-defense brand has been waiting for an opportunity like ... taking their personal safety into their own hands. , The ads focus on their ...
(Date:9/21/2017)... (PRWEB) , ... September 21, 2017 , ... ... in their communities, nine governmental public health departments have been awarded five-year accreditation ... decisions mean that the benefits of being served by a PHAB-accredited health ...
Breaking Medicine News(10 mins):
(Date:9/13/2017)... , Sept. 13, 2017   OrthoAtlanta has ... the Atlanta Football Host Committee (AFHC) for the 2018 College ... Jan. 8, 2018, at Mercedes-Benz Stadium in Atlanta, ... of the AFHC "I,m In" campaign, participating in many activities ... ...
(Date:9/12/2017)... , Sept. 12, 2017  Consumer reviews on the independent review ... as the number one company for hearing aids, ranking it higher ... other brands. ... Named #1 by Consumers For Hearing Aids ... Embrace Hearing is an online store that provides high performance, state-of-the-art, ...
(Date:9/9/2017)... ... DC ... th – Monday, September 18 th .The Brain Tumor Foundation (BTF) ... to the public.Where:  BTF,s Mobile MRI Unit – ... NW, Washington, D.C.What:BTF brings its nationwide initiative, the Road to Early Detection ...
Breaking Medicine Technology: