Repeat mediastinoscopy in the staging of lung cancer.
OBJECTIVE
Despite technical difficulties due to mediastinal fibrosis, repeat mediastinoscopy can be a valuable tool in the restaging of lung cancer. It provides essential pathological information on mediastinal invasion when selecting patients for surgical resection after induction chemotherapy in stage IIIa disease. The aim of our study was to evaluate the feasibility, sensitivity and accuracy of repeat mediastinoscopy.


METHODS
From 1994 to 1997 we performed a repeat mediastinoscopy in 15 patients (13 men, two women) with bronchogenic carcinoma. Their age ranged from 49 to 75 years. (mean 64.7). Seven patients had induction chemotherapy for a non-small cell bronchogenic carcinoma with positive N2 nodes on mediastinoscopy. Four patients had a second primary contralateral lung cancer, one had a locoregional recurrence of bronchogenic carcinoma. The other three had a first mediastinoscopy for other reasons than lung cancer, repeat mediastinoscopy being performed for staging of malignant disease.


RESULTS
In all 15 patients it was possible to perform a complete repeat mediastinoscopy. In one patient repeat mediastinoscopy turned out to be false negative, so, in our series, sensitivity was 87.5%, specificity 100% and accuracy 93.7%.


CONCLUSIONS
Previous mediastinoscopy is no contraindication for a repeat one. Repeat mediastinoscopy offers valuable pathological information in restaging of lung cancer.
Department of Surgery, Antwerp University Hospital, Edegem, Belgium.
M
M
Pauwels
P
P
Van Schil
W
W
De Backer
F
F
Van den Brande
E
E
Eyskens
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002283:Carcinoma, Bronchogenic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D005188:False Negative Reactions; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging / Q000379:methods*; D011013:Pneumonectomy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents