C Fournier1, C Hermant2, V Gounant3, B Escarguel4, Y Thibout5, S Lachkar6, C Raspaud7, J-M Vergnon5. 1. Pôle cardiovasculaire et pulmonaire, clinique de pneumologie, hôpital Calmette, CHU de Lille, 59000 Lille, France. Electronic address: clement.fournier@chru-lille.fr. 2. Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31000 Toulouse, France. 3. Service de pneumologie et service de chirurgie thoracique, hôpital Tenon, GHU Est, AP-HP, 75000 Paris, France. 4. Service de pneumologie, hôpital Saint-Joseph, 13000 Marseille, France. 5. Service de pneumologie et oncologie thoracique, hôpital Nord, CHU de Saint-Étienne, 42000 Saint-Étienne, France. 6. Service de pneumologie, hôpital Charles-Nicolle, CHU de Rouen, 76000 Rouen, France. 7. Service de pneumologie, clinique Pasteur, 31000 Toulouse, France.
Abstract
INTRODUCTION: Mediastinal lymphadenopathy in patients with extrathoracic malignancy is common. To obtain tissue proof of metastatic spread, EBUS-TBNA is an alternative to mediastinoscopy or thoracoscopy, but there are limited data about its diagnostic performance. The aim of this study was to determine the diagnostic accuracy of EBUS-TBNA for the evaluation of mediastinal lymphadenopathy in patients with extrathoracic cancers. METHODS: We performed a multicenter retrospective study based on an online questionnaire to collect data from January 2011 to December 2012 in all patients with proven extrathoracic malignancy (current or past) and suspected mediastinal lymph node metastases who underwent EBUS-TBNA for diagnosis. RESULTS: Hundred and eighty-five patients were included. Extrathoracic malignancies observed were urological (43), breast (35), gastrointestinal (33), head and neck (30), melanoma (11), lymphoma (6), and others (27). EBUS-TBNA confirmed malignancy in 93 patients (50.3%): concordant metastases in 67 (36.2%); new lung cancer in 25 (13.5%); and 1 unidentified cancer. The diagnostic accuracy, sensitivity, specificity, negative predictive value, and positive predictive value were respectively 54.6%, 68.4%, 100%, 53.3%, and 100%. CONCLUSION: Mediastinoscopy remain the reference, but EBUS-TBNA may be considered as first line investigation in patients with suspected mediastinal lymph node metastases and extrathoracic malignancy. It prevented a surgical procedure in 50.3% of patients.
INTRODUCTION:Mediastinal lymphadenopathy in patients with extrathoracic malignancy is common. To obtain tissue proof of metastatic spread, EBUS-TBNA is an alternative to mediastinoscopy or thoracoscopy, but there are limited data about its diagnostic performance. The aim of this study was to determine the diagnostic accuracy of EBUS-TBNA for the evaluation of mediastinal lymphadenopathy in patients with extrathoracic cancers. METHODS: We performed a multicenter retrospective study based on an online questionnaire to collect data from January 2011 to December 2012 in all patients with proven extrathoracic malignancy (current or past) and suspected mediastinal lymph node metastases who underwent EBUS-TBNA for diagnosis. RESULTS: Hundred and eighty-five patients were included. Extrathoracic malignancies observed were urological (43), breast (35), gastrointestinal (33), head and neck (30), melanoma (11), lymphoma (6), and others (27). EBUS-TBNA confirmed malignancy in 93 patients (50.3%): concordant metastases in 67 (36.2%); new lung cancer in 25 (13.5%); and 1 unidentified cancer. The diagnostic accuracy, sensitivity, specificity, negative predictive value, and positive predictive value were respectively 54.6%, 68.4%, 100%, 53.3%, and 100%. CONCLUSION: Mediastinoscopy remain the reference, but EBUS-TBNA may be considered as first line investigation in patients with suspected mediastinal lymph node metastases and extrathoracic malignancy. It prevented a surgical procedure in 50.3% of patients.
Authors: Samuel Galante Romanini; Arthur Ferraz de Almeida; Juliana Silveira Lima de Castro; Juan Pablo Román Serrano; Isabela Trindade Torres; José Celso Ardengh Journal: Turk Thorac J Date: 2021-05
Authors: Justyna Błach; Małgorzata Frąk; Pawel Krawczyk; Juliusz Pankowski; Adam Pankowski; Jarosław Buczkowski; Artur Szlubowski; Jan Siwiec; Piotr Krudyś; Marek Michnar; Robert Kieszko; Janusz Milanowski Journal: BMJ Open Date: 2021-08-09 Impact factor: 3.006