Role of computed tomography and mediastinoscopy in preoperative staging of lung carcinoma.
One hundred fifty-three patients with bronchogenic carcinoma were evaluated prospectively by CT and mediastinoscopy. Nodes larger than 5 mm were considered potentially metastatic. All results were correlated with surgical findings. Computed tomography is more sensitive (89%) in the detection of mediastinal metastases than mediastinoscopy (67%). Computed tomography has a poor predictive value (47%); however, a negative examination is highly accurate (89%). Within a group of 100 node sites, 72% of the nodes involved by tumor were larger than 1 cm in diameter. Squamous cell carcinoma and adenocarcinoma have the highest percentages of sensitivity by CT. The very low incidence of metastatic involvement in nodes under 5 mm allows one to forego mediastinoscopy in the presence of a negative CT.
D000230:Adenocarcinoma / Q000473:pathology; D002283:Carcinoma, Bronchogenic / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008481:Mediastinoscopy; D009367:Neoplasm Staging; D011300:Preoperative Care; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed