ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Carolyn E. Reed
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wallace, M. B.
Right arrow Articles by Reed, C. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wallace, M. B.
Right arrow Articles by Reed, C. E.
Related Collections
Right arrow Lung - cancer

Ann Thorac Surg 2001;72:1861-1867
© 2001 The Society of Thoracic Surgeons

Original article: general thoracic

Endoscopic ultrasound-guided fine needle aspiration for staging patients with carcinoma of the lung

Michael B. Wallace, MD, MPH*a, Gerard A. Silvestri, MD, MSb, Anand V. Sahai, MD, MS, (Epid)a,b,c,d, Robert H. Hawes, MDa, Brenda J. Hoffman, MDa, Valerie Durkalski, MPHc, Winnie S. Hennesey, RN, MSNa,b,c,d, Carolyn E. Reed, MDd

a Division of Gastroenterology and Hepatology/Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA
b Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
c The Clinical Innovation Group, Medical University of South Carolina, Charleston, South Carolina, USA
d Division of Cardiovascular and Thoracic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA

Accepted for publication August 6, 2001.

* Address reprint requests to Dr Wallace, Division of Gastroenterology and Hepatology, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 210, Charleston, SC 29425, USA
e-mail: wallacem{at}musc.edu

Background. Endoscopic ultrasound (EUS)-guided fine needle aspiration is a safe, cost-effective procedure that can confirm the presence of mediastinal lymph node metastases and mediastinal tumor invasion. We studied the accuracy of EUS in a large population of lung cancer patients with and without enlarged mediastinal lymph nodes on computed tomographic (CT) scan.

Methods. From 1996 to 2000 all patients referred to our institution with lung tumors and no proven distant metastases were considered for EUS and surgical staging. Patients had endoscopic ultrasound with fine needle aspiration of abnormal appearing mediastinal lymph nodes and evaluation for mediastinal invasion of tumor (stage III or IV disease). Patients without confirmed stage III or IV disease had surgical staging.

Results. Two hundred seventy-seven patients met the inclusion criteria, including 121 who had EUS. Endoscopic ultrasound and fine needle aspiration detected stage III or IV disease in 85 of 121 (70%). Among patients with enlarged lymph nodes on CT, 75 of 97 (77%) had stage III or IV disease detected by EUS. Among a small cohort of patients without enlarged mediastinal lymph nodes on CT, 10 of 24 (42%) had stage III or IV disease detected by EUS. For mediastinal lymph nodes only, the sensitivity of endoscopic ultrasound and CT was 87%. The specificity of EUS (100%) was superior to that of CT (32%) (p < 0.001).

Conclusions. Endoscopic ultrasound with fine needle aspiration identified and histologically confirmed mediastinal disease in more than two thirds of patients with carcinoma of the lung who have abnormal mediastinal CT scans. Although mediastinal disease was more likely in patients with an abnormal mediastinal CT, EUS also detected mediastinal disease in more than one third of patients with a normal mediastinal CT and deserves further study. Endoscopic ultrasound should be considered a first line method of presurgical evaluation of patients with tumors of the lung.




This article has been cited by other articles:


Home page
 Postgrad. Med. J.Home page
G A Silvestri and S G Spiro
Carcinoma of the bronchus 60 years later
Postgrad. Med. J., April 1, 2008; 84(990): 182 - 187.
[Full Text] [PDF]

Home page
 JAMAHome page
M. B. Wallace, J. M. S. Pascual, M. Raimondo, T. A. Woodward, B. L. McComb, J. E. Crook, M. M. Johnson, M. A. Al-Haddad, S. A. Gross, S. Pungpapong, et al.
Minimally Invasive Endoscopic Staging of Suspected Lung Cancer
JAMA, February 6, 2008; 299(5): 540 - 546.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. D. Vincent, E. El-Bayoumi, B. Hoffman, P. Doelken, J. DeRosimo, C. Reed, and G. A. Silvestri
Real-Time Endobronchial Ultrasound-Guided Transbronchial Lymph Node Aspiration
Ann. Thorac. Surg., January 1, 2008; 85(1): 224 - 230.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
M. J. Krasna
Stage-specific Therapy for Esophageal Cancer: The Role of Multimodality Therapy
ASCO Educational Book, January 1, 2008; 2008(1): e19 - e22.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. C. Detterbeck, M. A. Jantz, M. Wallace, J. Vansteenkiste, and G. A. Silvestri
Invasive Mediastinal Staging of Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)
Chest, September 1, 2007; 132(3_suppl): 202S - 220S.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. Singh, B. Camazine, Y. Jadhav, R. Gupta, P. Mukhopadhyay, A. Khan, R. Reddy, Q. Zheng, D. D. Smith, R. Khode, et al.
Endoscopic Ultrasound As a First Test for Diagnosis and Staging of Lung Cancer: A Prospective Study
Am. J. Respir. Crit. Care Med., February 15, 2007; 175(4): 345 - 354.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. G. Micames, D. C. McCrory, D. A. Pavey, P. S. Jowell, and F. G. Gress
Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Non-small Cell Lung Cancer Staging: A Systematic Review and Metaanalysis
Chest, February 1, 2007; 131(2): 539 - 548.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. J. F. Herth, K. F. Rabe, S. Gasparini, and J. T. Annema
Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions
Eur. Respir. J., December 1, 2006; 28(6): 1264 - 1275.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
G A Silvestri and S G Spiro
Carcinoma of the bronchus 60 years later.
Thorax, December 1, 2006; 61(12): 1023 - 1028.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. Lai
Endoscopic Ultrasound-Guided Fine Needle Aspiration for Diagnosis of Recurrent Nonsmall Cell Lung Cancer
Ann. Thorac. Surg., December 1, 2005; 80(6): 2346 - 2349.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
V. W. Rusch
Mediastinoscopy: An Endangered Species?
J. Clin. Oncol., November 20, 2005; 23(33): 8283 - 8285.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. A. Eloubeidi, A. Tamhane, V. K. Chen, and R. J. Cerfolio
Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Patients With Non-Small Cell Lung Cancer and Prior Negative Mediastinoscopy
Ann. Thorac. Surg., October 1, 2005; 80(4): 1231 - 1239.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. G. Tournoy, M. M. Praet, G. Van Maele, and J. P. Van Meerbeeck
Esophageal Endoscopic Ultrasound With Fine-Needle Aspiration With an On-site Cytopathologist: High Accuracy for the Diagnosis of Mediastinal Lymphadenopathy
Chest, October 1, 2005; 128(4): 3004 - 3009.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. Kanoh, T. Miyazawa, N. Kurimoto, Y. Iwamoto, Y. Miyazu, and N. Kohno
Endobronchial Ultrasonography Guidance for Transbronchial Needle Aspiration Using a Double-Channel Bronchoscope
Chest, July 1, 2005; 128(1): 388 - 393.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
G. Caddy, M. Conron, G. Wright, P. Desmond, D. Hart, and R. Y. Chen
The accuracy of EUS-FNA in assessing mediastinal lymphadenopathy and staging patients with NSCLC
Eur. Respir. J., March 1, 2005; 25(3): 410 - 415.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
R. C. Rintoul, K. M. Skwarski, J. T. Murchison, W. A. Wallace, W. S. Walker, and I. D. Penman
Endobronchial and endoscopic ultrasound-guided real-time fine-needle aspiration for mediastinal staging
Eur. Respir. J., March 1, 2005; 25(3): 416 - 421.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. B. Wallace, M. I. Block, W. Gillanders, J. Ravenel, B. J. Hoffman, C. E. Reed, M. Fraig, D. Cole, and M. Mitas
Accurate Molecular Detection of Non-small Cell Lung Cancer Metastases in Mediastinal Lymph Nodes Sampled by Endoscopic Ultrasound-Guided Needle Aspiration
Chest, February 1, 2005; 127(2): 430 - 437.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. K. LeBlanc, B. M. Devereaux, T. F. Imperiale, K. Kesler, J. M. DeWitt, O. Cummings, D. Ciaccia, S. Sherman, P. Mathur, D. Conces, et al.
Endoscopic Ultrasound in Non-Small Cell Lung Cancer and Negative Mediastinum on Computed Tomography
Am. J. Respir. Crit. Care Med., January 15, 2005; 171(2): 177 - 182.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
S M Wildi, M A Judson, M Fraig, W E Fickling, N Schmulewitz, S Varadarajulu, S S Roberts, P Prasad, R H Hawes, M B Wallace, et al.
Is endosonography guided fine needle aspiration (EUS-FNA) for sarcoidosis as good as we think?
Thorax, September 1, 2004; 59(9): 794 - 799.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
B. C. Jacobson, M. K. Gould, G. A. Silvestri, F. Detterbeck, A. Papagiannis, A. Buyukcelik, B. Yalcin, G. Utkan, A. Spira, and D. S. Ettinger
Multidisciplinary Management of Lung Cancer
N. Engl. J. Med., May 6, 2004; 350(19): 2008 - 2010.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. B. Wallace, J. Ravenel, M. I. Block, M. Fraig, G. Silvestri, S. Wildi, N. Schmulewitz, S. Varadarajulu, S. Roberts, B. J. Hoffman, et al.
Endoscopic ultrasound in lung cancer patients with a normal mediastinum on computed tomography
Ann. Thorac. Surg., May 1, 2004; 77(5): 1763 - 1768.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
D. G. Pfister, D. H. Johnson, C. G. Azzoli, W. Sause, T. J. Smith, S. Baker Jr, J. Olak, D. Stover, J. R. Strawn, A. T. Turrisi, et al.
American Society of Clinical Oncology Treatment of Unresectable Non-Small-Cell Lung Cancer Guideline: Update 2003
J. Clin. Oncol., January 15, 2004; 22(2): 330 - 353.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. B. Wallace, M. Block, B. J. Hoffman, R. H. Hawes, G. Silvestri, C. E. Reed, M. Mitas, J. Ravenel, M. Fraig, S. Miller, et al.
Detection of Telomerase Expression in Mediastinal Lymph Nodes of Patients with Lung Cancer
Am. J. Respir. Crit. Care Med., June 15, 2003; 167(12): 1670 - 1675.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Kimura, N. Iwai, S. Ando, K. Kakizawa, N. Yamamoto, H. Hoshino, and T. Anayama
A prospective study of indications for mediastinoscopy in lung cancer with CT findings, tumor size, and tumor markers
Ann. Thorac. Surg., June 1, 2003; 75(6): 1734 - 1739.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. A. Silvestri, B. Hoffman, and C. E. Reed
One From Column A: Choosing Between CT, Positron Emission Tomography, Endoscopic Ultrasound With Fine-Needle Aspiration, Transbronchial Needle Aspiration, Thoracoscopy, Mediastinoscopy, and Mediastinotomy for Staging Lung Cancer
Chest, February 1, 2003; 123(2): 333 - 335.
[Full Text] [PDF]

Home page
 ChestHome page
A. Fritscher-Ravens, K. H. Bohuslavizki, L. Brandt, C. Bobrowski, C. Lund, W. T. Knofel, and A. Pforte
Mediastinal Lymph Node Involvement in Potentially Resectable Lung Cancer: Comparison of CT, Positron Emission Tomography, and Endoscopic Ultrasonography With and Without Fine-Needle Aspiration
Chest, February 1, 2003; 123(2): 442 - 451.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
M. Mitas, D. J. Cole, L. Hoover, M. M. Fraig, K. Mikhitarian, M. I. Block, B. J. Hoffman, R. H. Hawes, W. E. Gillanders, and M. B. Wallace
Real-Time Reverse Transcription-PCR Detects KS1/4 mRNA in Mediastinal Lymph Nodes from Patients with Non-Small Cell Lung Cancer
Clin. Chem., February 1, 2003; 49(2): 312 - 315.
[Full Text] [PDF]

Home page
 ChestHome page
E. M. Toloza, L. Harpole, F. Detterbeck, and D. C. McCrory
Invasive Staging of Non-small Cell Lung Cancer: A Review of the Current Evidence
Chest, January 1, 2003; 123(1_suppl): 157S - 166S.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. C. Detterbeck, M. M. DeCamp Jr., L. J. Kohman, and G. A. Silvestri
Invasive Staging: The Guidelines
Chest, January 1, 2003; 123(1_suppl): 167S - 175S.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. G. Spiro and J. C. Porter
Lung Cancer--Where Are We Today?: Current Advances in Staging and Nonsurgical Treatment
Am. J. Respir. Crit. Care Med., November 1, 2002; 166(9): 1166 - 1196.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
S. Raja, T. El-Hefnawy, L. A. Kelly, M. L. Chestney, J. D. Luketich, and T. E. Godfrey
Temperature-controlled Primer Limit for Multiplexing of Rapid, Quantitative Reverse Transcription-PCR Assays: Application to Intraoperative Cancer Diagnostics
Clin. Chem., August 1, 2002; 48(8): 1329 - 1337.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2001 by The Society of Thoracic Surgeons.