Mediastinal staging (take home messages).
Mediastinal lymph-node involvement is still the major prognostic factor in NSCLC. Currently, cervical mediastinoscopy is the gold standard of mediastinal lymph-node staging. However, less invasive methods such as transbronchial or transoesophageal FNA are becoming more popular and might replace or adjunct mediastinoscopy under certain circumstances. It has been clearly shown that FDG PET is more accurate than CT for the detection of mediastinal lymph-node metastases. However, a positive finding on the PET scan implies that these lymph nodes have to be examined by invasive methods (e.g. mediastinoscopy). It has been demonstrated that PET might be useful in order to detect non-symptomatic distant metastases. The method of pathological analysis of the lymph nodes is critical for the correct determination of the N stage.
Passlick
Bernward
B
Dept. of Thoracic Surgery, University Hospital Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany. passlick@ch11.ukl.uni-freiburg.de
D001707:Biopsy, Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008481:Mediastinoscopy; D008482:Mediastinum / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed / Q000379:methods; D018084:Ultrasonography, Interventional
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18