Abstract
Cervical mediastinoscopy is a widely used procedure in the invasive staging of non-small cell lung cancer (NSCLC). lung cancer (NSCLC). It is a safe invasive diagnostic procedure that has been shown to have a morbidity rate of 1.7%, a mortality rate of 0.07%, and an emergency thoracotomy rate of 0.12%. Most commonly, it is done after noninvasive staging modalities have demonstrated no advanced disease, and is the final step in the determination of the benefit of surgical resection. Mediastinoscopy policies differ among countries, institutions, and surgeons, but generally it is done either selectively or routinely. selectively or routinely. There is a strong consensus for performing this in patients with enlarged mediastinal lymph nodes, but there is less than widespread acceptance for performing it in the setting of normal-sized nodes.
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References
Hammoud ZT, Anderson RC, Meyers BF, et al. The current role of mediastinoscopy in the evaluation of thoracic disease. J Thorac Cardiovasc Surg 1999;118:894–899.
Luke WP, Pearson FG, Todd TR, et al. Prospective evaluation of mediastinoscopy for assessment of carcinoma of the lung. J Thorac Cardiovasc Surg 1986;91:53–56.
Cybulsky IJ, Bennett WF. Mediastinoscopy as a routine outpatient procedure. Ann Thorac Surg 1994;58:176–178.
Ginsberg RJ, Rice TW, Goldberg M, et al. Extended cervical mediastinoscopy: a single staging procedure for bronchogenic carcinoma of the left upper lobe. J Thorac Cardiovasc Surg 1987;94:673–678.
Coughlin M, Deslauriers J, Beaulieu M, et al. Role of mediastinoscopy in pretreatment staging of patients with primary lung cancer. Ann Thorac Surg 1985;40:556–560.
Gould MK, Kuschner WG, Rydzak CE, et al. Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small cell lung cancer. Ann Int Med 2003;139:879–892.
The Canadian Lung Oncology Group. Investigation for mediastinal disease in patients with apparently operable lung cancer. Ann Thorac Surg 1995;60:1382–1389.
Douillard JY, Rosell R, De Lena M, et al. ANITA: phase III adjuvant vinorelbine and cisplatin versus observation in completely resected non-small cell lung cancer patients: final results after 70-month median follow-up [abstract]. Proc Am Soc Oncol 2005; Abstract 7013.
The International Association for Lung Cancer Trial Collaborative Group. Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. N Engl J Med 2004;350:351–360.
Viney RC, Boyer MJ, King MT, et al. Randomized controlled trial of the role of positron emission tomography in the management of stage I and II non-small-cell lung cancer. J Clin Oncol 2004;22:2357–2362.
Meyers BF, Haddad FJ, Siegel BA, et al. Cost-effectiveness of routine mediastinoscopy in CT-and PET-screened patients with stage I lung cancer. J Thorac Cardiovasc Surg 2006;131:822–829.
Choi YS, Shim YM, Kim J, Kim K. Mediastinoscopy in patients with clinical stage I non-small-cell lung cancer. Ann Thorac Surg 2003;75:364–366.
Albain KS, Swann RS, Rusch VR, et al. Phase III study of concurrent chemotherapy and radiotherapy (CT/RT) vs CT/RT followed by surgical resection for stage IIIA (pN2) non-small cell lung cancer: outcomes update of north american intergroup 0139 (RTOG 9309) [abstract]. Proc Am Soc Clin Oncol 2005; Abstract 7014
Ferguson MK. Optimal management when unsuspected N2 nodal disease is identified during thoracotomy for lung cancer: cost-effectiveness analysis. J Thorac Cardiovasc Surg 2003;126:1935–1942.
Alam N, Shepherd F, Winton T, et al. Compliance with post-operative adjuvant chemotherapy in non-small-cell lung cancer. An analysis of national cancer institute of Canada and intergroup trial JBR10 and a review of the literature. Lung Cancer 2005;47:385–394.
Pisters KM, Ginsberg RJ, Giroux DJ, et al. Bimodality lung oncology team trial of induction paclitaxel/carboplatin in early-stage non-small cell lung cancer: long-term follow-up of a phase II trial. Proc Am Soc Clin Oncol 2003;22:633.
Depierre A, Milleron D, Moro-Sibilot D, et al. Preoperative chemotherapy followed by surgery compared with primary surgery in resectable stage I (except T1N0), II, and IIIA non-small cell lung cancer. J Clin Oncol 2002;20:247–253.
Gonzalez-Stawinski GV, Lemaire A, Merchant F, et al. A comparative analysis of positron emission tomography and mediastinoscopy in staging nonsmall cell lung cancer. J Thorac Cardiovasc Surg 2003;126:1900–1905.
Detterbeck FC, Jones DR, Parker LA. Intrathoracic staging. In: Detterbeck FC, Rivera MP, Socinski MA, eds. Diagnosis and Treatment of Lung Cancer. Philadelphia: Saunders; 2001:73–93.
De Leyn P, Vansteenkiste J, Cuypers P, et al. Role of cervical mediastinoscopy in staging of nonsmall cell lung cancer without enlarged mediastinal lymph nodes on CT scan. Eur J Cardio-Thorac Surg 1997;12:706–712.
Pieterman RM, Van Putten JW, Meuzelaar JJ, et al. Preoperative staging of non-small-cell lung cancer with positron-emission tomography. N Engl J Med 2000;343:254–261.
Suzuki K, Nagai K, Yoshida J, et al. Clinical predictors of N2 disease in the setting of a negative computed tomographic scan in patients with lung cancer. J Thorac Cardiovasc Surg 1999;117:593–598.
Kim K, Rice TW, Murthy SC, et al. Combined bronchoscopy, mediastinoscopy, and thoracotomy for lung cancer: who benefits? J Thorac Cardiovasc Surg 2004;127:850–856.
Daly BD, Mueller JD, Faling LJ, et al. N2 lung cancer: outcome in patients with false-negative computed tomographic scans of the chest. J Thorac Cardiovasc Surg 1993;105:904–910.
Vallieres E, Waters PF. Incidence of mediastinal node involvement in clinical T1 bronchogenic carcinomas. Can J Surg 1987;30:341–342.
Lewis J W, Pearlberg J L, Beute G H, et al. Can computed tomography of the chest stage lung cancer? — yes and no. Ann Thorac Surg 1990;49:591–596.
Funatsu T, Matsubara Y, Ikeda S, et al. Preoperative mediastinoscopic assessment of N factors and the need for mediastinal lymph node dissection in T1 lung cancer. J Thorac Cardiovasc Surg 1994;108:321–328.
Mckenna RJ, Libshitz HI, Mountain CE, et al. Roentgenographic evaluation of mediastinal nodes for preoperative assessment in lung cancer. Chest 1985;88:206–210.
Tahara RW, Lackner RP, Graver LM. Is there a role for routine mediastinoscopy in patients with peripheral T1 lung cancers? Am J Surg 2000;180:488–492.
Dillemans B, Deneffe G, Verschakelen J, et al. Value of computed tomography and mediastinoscopy in preoperative evaluation of mediastinal nodes in non-small cell lung cancer: a study of 569 patients. Eur J Cardiothorac Surg 1994;8:37–42.
Rhoads AC, Thomas JH, Hermreck AS, et al. Comparative studies of computed tomography and mediastinoscopy for the staging of bronchogenic carcinoma. Am J Surg 1986;152:587–591.
Forse RA, Dutton JW, Munro DD. Mediastinoscopy for diagnosing diseases of the lung other than primary carcinoma. Can J Surg 1978;21:438–440.
Porte H, Roumilhac D, Eraldi L, et al. The role of mediastinoscopy in the diagnosis of mediastinal lymphadenopathy. Eur J Cardiothorac Surg 1998;13:196–199.
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Uy, K.F.L., Waddell, T.K. (2007). Routine Mediastinoscopy for Clinical Stage I Lung Cancer. In: Ferguson, M.K. (eds) Difficult Decisions in Thoracic Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-474-8_7
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DOI: https://doi.org/10.1007/978-1-84628-474-8_7
Publisher Name: Springer, London
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