title: Restaging the mediastinum in non-small cell lung cancer after induction therapy: non-invasive versus invasive procedures.
abstract: OBJECTIVE
  Nodal status after induction therapy in patients with stage III non-small cell lung cancer (NSCLC) is an independent prognostic factor for survival. Prognosis is poor in patients with persisting mediastinal lymph node involvement.
  
  
  METHODS
  From February 2000 to September 2007, restaging for NSCLC was performed in 25 patients (23 men, 2 women) by computed tomography (CT), positron emission tomography (PET) as well as repeat mediastinoscopy. Initial proof of N2 or N3 disease was obtained by mediastinoscopy.
  
  
  RESULTS
  The non-invasive restaging modalities CT and PET had a rather low accuracy of 64% and 72%, respectively. Repeat mediastinoscopy performed better with an accuracy of 84%.
  
  
  CONCLUSIONS
  Histological proof of mediastinal involvement after induction therapy in NSCLC is necessary to select those patients who will benefit from surgical resection. When a first mediastinoscopy has been performed to obtain pathological proof of N2 or N3 disease, repeat mediastinoscopy proves to be more accurate than CT or PET scanning for mediastinal restaging.
authors.affiliation: Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium. Michele.De.Waele@uza.be
authors.forename: M
authors.initials: M
authors.lastname: De Waele
authors.forename: J
authors.initials: J
authors.lastname: Hendriks
authors.forename: P
authors.initials: P
authors.lastname: Lauwers
authors.forename: M
authors.initials: M
authors.lastname: Hertoghs
authors.forename: L
authors.initials: L
authors.lastname: Carp
authors.forename: R
authors.initials: R
authors.lastname: Salgado
authors.forename: P
authors.initials: P
authors.lastname: Van Schil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D008481:Mediastinoscopy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies