Restaging the mediastinum in non-small cell lung cancer after induction therapy : non-invasive versus invasive proceduresRestaging the mediastinum in non-small cell lung cancer after induction therapy : non-invasive versus invasive procedures
Faculty of Medicine and Health Sciences
Antwerp Surgical Training, Anatomy and Research Centre (ASTARC)
Thorax - en vaatheelkunde
Acta chirurgica Belgica. - Brussel, 1946 - 1996
111(2011):3, p. 161-164
University of Antwerp
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%. Conclusion : 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.