LYMPH NODE UPSTAGING AFTER SURGERY IN PATIENTS WITH NEGATIVE MEDIASTINAL STAGING BY EBUS

Authors

  • Daniel Cabral Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal https://orcid.org/0000-0002-2891-5806
  • Cristina Rodrigues Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal
  • Mariana Antunes Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal
  • Agata Nawojowska Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal
  • Telma Calado Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal
  • Carolina Torres Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal
  • Magda Alvoeiro Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal
  • Samuel Mendes Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal
  • Francisco Félix Thoracic Surgery Department, Hospital Pulido Valente, CHULN, Lisboa, Portugal

DOI:

https://doi.org/10.48729/pjctvs.220

Keywords:

EBUS, Mediastinal Staging

Abstract

Introduction: Mediastinal staging is a hot topic in thoracic oncology. According to the guidelines, and besides other criteria, in the presence of a primary lung cancer with increased mediastinal lymph node uptake on PET-CT, a negative result after lymph node sampling by Endobronchial Ultrasound (EBUS) is not enough to rule out mediastinal lymph node involve- ment, demanding a cervical mediastinoscopy to vouch for the results.

Methods and Objectives: In order to study the percentage of lymph node surgical upstaging in patients with neg- ative mediastinal node staging by EBUS and evaluate the role of mediastinoscopy in these patients, we conducted a search in our department’s database using the key-word EBUS in the period concerned between January 2014 and August 2020. A total of 302 patients were found. After applying defined criteria, we obtained 42 cases.

Results: Lymph node surgical upstaging occurred in 11 (26%) patients, of which 8 were upstaged to N2 and 3 to N1. Most of the cases were single station. Only in 5 (12% of the total) of the 11 patients, the upstaging was related to lymph node stations previously sampled by EBUS. Upstaging was more frequent among males and lower lobe tumours.

Discussion and Conclusions: Regarding the 8 upstage cases for N2, 5 were single station. Of these 8 cases, only 5 would be approachable by cervical mediastinoscopy. Furthermore, 2 of them were single station, eligible for upfront surgery. Then, only in 3 (7%) of the 42 cases cervical mediastinoscopy would be of foremost importance.

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References

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Published

04-01-2022

How to Cite

1.
Cabral D, Rodrigues C, Antunes M, Nawojowska A, Calado T, Torres C, Alvoeiro M, Mendes S, Félix F. LYMPH NODE UPSTAGING AFTER SURGERY IN PATIENTS WITH NEGATIVE MEDIASTINAL STAGING BY EBUS. Rev Port Cir Cardiotorac Vasc [Internet]. 2022 Jan. 4 [cited 2024 Mar. 29];28(4):25-30. Available from: https://pjctvs.com/index.php/journal/article/view/220

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