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The Annals of Thoracic Surgery, Vol 40, 57-59, Copyright © 1985 by The Society of Thoracic Surgeons

ARTICLES

The value of computed tomography in staging bronchogenic carcinoma: a changing role for mediastinoscopy

WG Graves, MJ Martinez, PL Carter, MJ Barry and JS Clarke

Forty-one patients underwent operative staging for bronchogenic carcinoma following computed tomography of the mediastinum between August, 1982, and March, 1984. Twenty-seven patients were classified as Stage I preoperatively; in 2 of them, positive mediastinal nodes were found at thoracotomy. For the 14 patients in whom positive nodes had been identified by computed tomographic (CT) scanning, staging was unchanged as a result of the findings at mediastinoscopy or thoracotomy or both. In this series, computed tomography had a sensitivity of 89%, a specificity of 100%, and an overall accuracy rate of 95%. We conclude that mediastinoscopy is not needed in patients without evidence of mediastinal nodal enlargement by CT scan; when performed, it should be guided toward those nodes identified as positive.

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