Korean J Thorac Cardiovasc Surg.  2007 Nov;40(11):745-751.

The Clinical Value of Mediastinoscopy in Preoperative Staging of Non-small Cell Lung Cancer

• Haam SJ
• Paik HC
• Kim DH
• Jeon SE
• Lee DY

Abstract

BACKGROUND: Mediastinoscopy is generally performed to confirm mediastinal lymph node metastasis in lung cancer patients. It still remains controversial whether mediastinoscopy should be performed in all patients with resectable non-small cell lung cancer (NSCLC). We studied the clinical value of mediastinoscopy in preoperative staging in NSCLC. MATERIAL AND METHOD: We retrospectively studied 90 NSCLC patients who underwent radiological evaluation and mediastinoscopy followed by surgical resection from March 2002 to December 2004. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each evaluation method were assessed and compared. RESULT: Specificity, PPV, NPV, and accuracy of mediastinoscopy were superior to those of radiological evaluation, but there was no significant difference in sensitivity. The sensitivity of mediastinoscopy was 28.6% in 62 patients with radiological N0/1 disease and 72.7% in 28 patients with radiological N2/3 disease. Seven of eight patients in whom positive nodes were not detected by the mediastinoscopy had subcarinal lymph node metastasis.
CONCLUSION
Considering its invasiveness, the difficulty to reach certain node stations, and its low sensitivity in radiological N0/1 disease, mediastinoscopy should be selectively performed in radiological N2/3 disease rather than in all radiological cancer stages.

Keyword

Carcinoma, non-small cell, lung; Mediastinoscopy

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Humans
Lung Neoplasms
Lymph Nodes
Mediastinoscopy*
Neoplasm Metastasis
Retrospective Studies
Sensitivity and Specificity