Role of fiberscopic transbronchial needle aspiration in the staging of N2 disease due to non-small cell lung cancer.
BACKGROUND
Transbronchoscopic needle aspiration (TBNA) can offer a unique opportunity to identify surgically unresectable lung cancer and to avoid surgical mediastinal exploration in many patients with mediastinal lymph node extension of the tumor. The aim of this study was to assess the yield of TBNA performed with either histology or cytology needles in mediastinal staging of N2 disease due to non-small cell lung cancer (NSCLC).


METHODS
Retrospective chart review was carried out on 194 TBNA procedures performed between January 1997 and September 2000 at a single institution. Inclusion criteria were pathologic evidence of NSCLC; contrast enhancement computed tomography scan of the chest suggesting N2 disease; and negative bronchoscopic examination for possible neoplastic lesions at the site of


RESULTS
Overall sensitivity and diagnostic accuracy were 71% and 73%, respectively, with no significant differences between 19-gauge and 22-gauge cytology needles. Procedures performed for right paratracheal and subcarinal lymph node stations had a significantly higher yield than those for the left paratracheal station.


CONCLUSIONS
TBNA mediastinal staging, performed during the initial diagnostic evaluation of NSCLC, can spare costs and risks of more invasive procedures in patients with inoperable tumors, in patients who are not candidates for operation because of coexistent significant comorbidities, and in patients with N2 disease.
Patelli
Marco
M
Department of Thoracic Diseases, Maggiore/Bellaria Hospitals, Bologna, Italy. marco.patelli@ausl.bologna.it
Lazzari Agli
Luigi
L
Poletti
Venerino
V
Trisolini
Rocco
R
Cancellieri
Alessandra
A
Lacava
Nicola
N
Falcone
Franco
F
Boaron
Maurizio
M
D001707:Biopsy, Needle / Q000295:instrumentation; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery; D000075202:Contraindications; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D019564:Unnecessary Procedures