JACKSONVILLE, Fla. Using two different endoscopes together is better than using one to stage lung cancer, and is also much more precise and less invasive than the surgical method now most commonly used, researchers at Mayo Clinic in Jacksonville, Fla., report in the Feb. 6 issue of the Journal of the American Medical Association.
This new technique, which uses two small flexible tubes, one of which is inserted into a patients esophagus to access lymph nodes in the back of the lungs while the other is placed into the trachea, or airway, to reach nodes at the front and sides, was 93 percent accurate in finding malignant lymph nodes in a group of 138 patients. This is substantially more precise than all other lung cancer staging methods now in use today, say the researchers, who tested three different methods of non-invasive staging in their study.
Both scopes together found more malignant lymph nodes than did the use of a single endoscope, says the studys lead investigator, Michael Wallace, M.D., M.P.H., Professor of Medicine at Mayo Clinic, Jacksonville, Fla. Doing both procedures at once takes little time, requires only a mild sedative, and patients go home the same day.
The combination technique was pioneered by Wallace, a gastroenterologist, and study co-author Jorge Pascual, M.D., a pulmonologist. Since the researchers have seen how effective this method is, the two tests are now used routinely at Mayo Clinic Jacksonville to stage lung cancer patients. The researchers are among the first to publish studies examining use of the two scopes, and this study is the largest and most comprehensive to date.
Lung cancer is the most common cause of cancer death. Treatment of the disease depends on whether the cancer has spread outside the lungs, and in order to know that, physicians need to biopsy (remove a small piece of tissue for examination) the lymph nodes that are adjacent to the organ. Patients whose cancer has not spread ca
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