Is there still a role for mediastinoscopy as the first mediastinal staging procedure in lung cancer?

Lung cancer staging has evolved with the advent of endobronchial and endoscopic ultrasound (EBUS and EUS) as an alternative to mediastinoscopy and other surgical staging techniques. This has led to the debate now as to what the first-line staging investigation should be. Mr Waller makes the case that although EBUS and EUS are welcomed staging techniques, mediastinoscopy still has an important role as the first-line staging investigation in specific scenarios (when there is potentially surgically resectable mediastinal disease). Dr Skwarski argues that EBUS and EUS should be used in conjunction with CT-PET and considered as a complete alternative to mediastinoscopy.