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Ann Thorac Surg 2003;75:1102-1106
© 2003 The Society of Thoracic Surgeons

Original article: general thoracic

Postinduction video-mediastinoscopy is as accurate and safe as video-mediastinoscopy in patients without pretreatment for potentially operable non–small cell lung cancer

Didier Lardinois, MDa*, Alex Schallberger, MDa, Daniel Betticher, MDb, Hans-Beat Ris, MDc

a Division of Thoracic Surgery, Inselspital Bern, Bern, Switzerland
b Institute of Medical Oncology, Inselspital Bern, Bern, Switzerland
c Department of Surgery, Centre Hôpitalier Universitaire Vaudois, Lausanne, Switzerland

Accepted for publication October 29, 2002.

* Address reprint requests to Dr Lardinois, Division of Thoracic Surgery, University Hospital, Raemistrasse 100, 8091 Zurich, Switzerland
e-mail: didier.lardinois{at}chi.usz.ch

BACKGROUND: Prospective assessment of accuracy and safety of video-mediastinoscopy (VMS) in patients without pretreatment and those after induction therapy for potentially operable non–small cell lung cancer.

METHODS: Between 1996 and 1999, 219 patients underwent VMS at our institution: 195 patients without pretreatment and 24 after completion of induction therapy. Mediastinal lymph nodes were dissected and biopsied according to the American Thoracic Society (ATS) lymph node mapping system using a video-assisted approach. The accuracy of VMS was assessed for each patient according to the results obtained from mediastinal lymph node dissection (MLND) performed during lung resection.

RESULTS: Video-mediastinoscopy in patients without pretreatment revealed a sensitivity, specificity, and accuracy as compared with MLND of 87%, 100%, and 95.6%, respectively, and a procedure-related complication rate of 4% (8/195 patients). Video-mediastinoscopy in patients after induction therapy revealed a sensitivity, specificity, and accuracy of 81%, 100%, and 91% as compared with MLND, without apparent complications.

CONCLUSIONS: Video-mediastinoscopy performed after induction therapy for non–small cell lung cancer is as accurate as mediastinoscopy in patients without pretreatment and did not confer additional morbidity.




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