title: Importance of histological verification of mediastinal lymphadenopathy in exact staging of non-small cell bronchogenic carcinoma.
abstract: BACKGROUND
  Diagnostics and treatment of bronchogenic non-small cell lung carcinoma is a severe clinical problem. Radical surgery is the major treatment modality with the highest chance for a long-time survival. The aim of the study was to map metastasizing of bronchogenic non-small cell lung carcinoma into homolateral mediastinal lymph nodes and to assess the importance of histological verification of mediastinal lymphadenectomy for exact staging and treatment.
  
  
  METHODS
  Study of 29 patients with non-small cell lung carcinoma in stage IIIa, IIIb and IV (TNM classification) diagnosed from September 2006 to March 2007, with mediastinal lymph nodes invasion according to CT, and with subsequent mediastinal lymph node dissection during autopsy.
  
  
  RESULTS
  50% of the right upper lobe tumors metastasized into group 1 nodes (N1-N4) and 50% into group 3 (N7). 66% of the right lower lobe tumors metastasized into group 3 nodes (N7) and 33.3% into group 1 (N1-4). 20.0% of the left upper lobe tumors metastasized into group 1 nodes (N1-4), 33.0% into group 2 (N5-6), 25.0% into group 3 (N7) and 16.7% into group 4 (N8-9). 23.5% of the left lower lobe tumors metastasized into group 1 nodes (N1-4), 23.5% into group 2 (N5-6), 23.5 % into group 4 (N8-9) and 29.5% into group 3 (N7). 27.6% of examined patients had false positivity of lymph node metastasis according to CT.
  
  
  CONCLUSIONS
  Histological verification of suspect mediastinal lymph nodes via Endobronchial Ultrasound Biopsy (EBUS) or mediastinoscopy or thoracoscopy is crucial for determining the stage of the disease according to the TNM classification. False positivity of imaging methods in diagnostics of non-small cell brochogenic carcinoma can contraindicate up to quarter of potentially operable patients (Tab. 3, Ref. 11).
authors.forename: V
authors.initials: V
authors.lastname: Hytych
authors.forename: R
authors.initials: R
authors.lastname: Pohnan
authors.forename: A
authors.initials: A
authors.lastname: Taskova
authors.forename: P
authors.initials: P
authors.lastname: Horazdovsky
authors.forename: Z
authors.initials: Z
authors.lastname: Konopa
authors.forename: R
authors.initials: R
authors.lastname: Demes
authors.forename: J
authors.initials: J
authors.lastname: Cermak
authors.forename: A
authors.initials: A
authors.lastname: Vrabcova
authors.forename: P
authors.initials: P
authors.lastname: Hoferka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000556:secondary*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008197:Lymph Node Excision; D008206:Lymphatic Diseases / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests