Postinduction video-mediastinoscopy is as accurate and safe as video-mediastinoscopy in patients without pretreatment for potentially operable non-small cell lung cancer.
BACKGROUND
Prospective assessment of accuracy and safety of video-mediastinoscopy (VMS) in patients without pretreatment and those after induction therapy for potentially operable non-small cell lung cancer.


METHODS
Between 1996 and 1999, 219 patients underwent VMS at our institution: 195 patients without pretreatment and 24 after completion of induction therapy. Mediastinal lymph nodes were dissected and biopsied according to the American Thoracic Society (ATS) lymph node mapping system using a video-assisted approach. The accuracy of VMS was assessed for each patient according to the results obtained from mediastinal lymph node dissection (MLND) performed during lung resection.


RESULTS
Video-mediastinoscopy in patients without pretreatment revealed a sensitivity, specificity, and accuracy as compared with MLND of 87%, 100%, and 95.6%, respectively, and a procedure-related complication rate of 4% (8/195 patients). Video-mediastinoscopy in patients after induction therapy revealed a sensitivity, specificity, and accuracy of 81%, 100%, and 91% as compared with MLND, without apparent complications.


CONCLUSIONS
Video-mediastinoscopy performed after induction therapy for non-small cell lung cancer is as accurate as mediastinoscopy in patients without pretreatment and did not confer additional morbidity.
Lardinois
Didier
D
Division of Thoracic Surgery and Institute of Medical Oncology, Inselspital Bern, Bern, Switzerland. didier.lardinois@chi.usz.ch
Schallberger
Alex
A
Betticher
Daniel
D
Ris
Hans-Beat
HB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008481:Mediastinoscopy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012680:Sensitivity and Specificity; D014741:Video Recording