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.
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