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 Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Schouwink, J. H.
Right arrow Articles by Baas, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schouwink, J. H.
Right arrow Articles by Baas, P.

Ann Thorac Surg 2003;75:1715-1718
© 2003 The Society of Thoracic Surgeons

Original article: general thoracic

The value of chest computer tomography and cervical mediastinoscopy in the preoperative assessment of patients with malignant pleural mesothelioma

J. Hugo Schouwink, MDa,e*, Leo Schultze Kool, MD, PhDb, Emiel J. Rutgers, MD, PhDc, Frans A. N. Zoetmulder, MD, PhDc, Nico van Zandwijk, MD, PhDa, Marc J. v.d. Vijver, MD, PhDd, Paul Baas, MD, PhDa

a Department of Thoracic Oncology, Amsterdam, The Netherlands
b Department ofRadiology, Amsterdam, The Netherlands
c Department ofSurgical Oncology, Amsterdam, The Netherlands
d Department ofPathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
e Department of Pulmonology, Medisch Spectrum Twente, Enschede, The Netherlands

Accepted for publication December 22, 2002.

* Address reprint requests to Dr Schouwink, Medisch Spectrum Twente, Department of Pulmonary Diseases, Postbus 50000, Enschede 7500 KA, The Netherlands
e-mail: j.schouwink{at}ziekenhuis-mst.nl

BACKGROUND: Patients with localized malignant pleural mesothelioma (MPM) can be considered for surgical resection with or without additional treatment. For this approach it is imperative to select patients without mediastinal lymph node involvement. In this study cervical mediastinoscopy (CM) is compared with computer tomography (CT) scanning for its diagnostic accuracy in assessing mediastinal lymph nodes during preoperative workup.

METHODS: Computer tomography scans of the chest and CM were performed in 43 patients with proven unilateral MPM. The CT scans were reviewed by one radiologist and two chest physicians. At CM the lymph node samples were taken from stations Naruke 2, 3, 4, and 7. Computer tomography and CM results were compared with final histopathologic findings obtained at thoracotomy or, if this was not performed, at CM.

RESULTS: Computer tomography scanning revealed pathologic enlarged lymph nodes with a shortest diameter of at least 10 mm in 17 of 43 patients (39%). There was histopathologic evidence of lymph node metastases at CM in 11 of these patients (26%). This resulted in a sensitivity of 60% and 80%, a specificity of 71% and 100%, and a diagnostic accuracy of 67% and 93% for CT and CM, respectively.

CONCLUSIONS: Cervical mediastinoscopy is a valuable diagnostic procedure for patients with MPM who are considered candidates for surgical-based therapy. Results of CM are more reliable than those obtained by CT scanning. Our data confirm results of previous studies reporting that mediastinal lymph node involvement is a frequent event in MPM.




This article has been cited by other articles:


Home page
 Clin. Cancer Res.Home page
K. G. Tournoy, S. A. Burgers, J. T. Annema, F. Vermassen, M. Praet, M. Smits, H. M. Klomp, J. P. van Meerbeeck, and P. Baas
Transesophageal Endoscopic Ultrasound with Fine Needle Aspiration in the Preoperative Staging of Malignant Pleural Mesothelioma
Clin. Cancer Res., October 1, 2008; 14(19): 6259 - 6263.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. M. Flores, T. Routledge, V. E. Seshan, J. Dycoco, M. Zakowski, Y. Hirth, and V. W. Rusch
The impact of lymph node station on survival in 348 patients with surgically resected malignant pleural mesothelioma: Implications for revision of the American Joint Committee on Cancer staging system
J. Thorac. Cardiovasc. Surg., September 1, 2008; 136(3): 605 - 610.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. R. M. Abdel Rahman, R. M. Gaafar, H. A. Baki, H. M. El Hosieny, F. Aboulkasem, E. G. Farahat, A. M. Nouh, and K. A. Mansour
Prevalence and Pattern of Lymph Node Metastasis in Malignant Pleural Mesothelioma
Ann. Thorac. Surg., August 1, 2008; 86(2): 391 - 395.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
J. W. van Sandick, I. Kappers, P. Baas, R. L. Haas, and H. M. Klomp
Surgical Treatment in the Management of Malignant Pleural Mesothelioma: A Single Institution's Experience
Ann. Surg. Oncol., June 1, 2008; 15(6): 1757 - 1764.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. C. Mineo, V. Ambrogi, E. Pompeo, A. Baldi, F. Stella, P. Aurea, and M. Marino
The Value of Occult Disease in Resection Margin and Lymph Node After Extrapleural Pneumonectomy for Malignant Mesothelioma
Ann. Thorac. Surg., May 1, 2008; 85(5): 1740 - 1746.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
H. L. Kindler, R. Bueno, and J. R. Testa
New Biomarkers, Surgical Controversies, and Rationally Targeted Therapies for Malignant Mesothelioma
ASCO Educational Book, January 1, 2008; 2008(1): 354 - 361.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
G. L. Ceresoli, C. Gridelli, and A. Santoro
Multidisciplinary Treatment of Malignant Pleural Mesothelioma
Oncologist, July 1, 2007; 12(7): 850 - 863.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. E. Martin-Ucar, A. Nakas, J. G. Edwards, and D. A. Waller
Case-control study between extrapleural pneumonectomy and radical pleurectomy/decortication for pathological N2 malignant pleural mesothelioma
Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 765 - 770.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. de Perrot, K. Uy, M. Anraku, M. S. Tsao, G. Darling, T. K. Waddell, A. F. Pierre, A. Bezjak, S. Keshavjee, and M. R. Johnston
Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma
J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 111 - 116.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. G. Edwards, D.J. Stewart, A. Martin-Ucar, S. Muller, C. Richards, and D. A. Waller
The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma
J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 981 - 987.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. C. Rice, J. J. Erasmus, C. W. Stevens, A. A. Vaporciyan, J. S. Wu, A. S. Tsao, G. L. Walsh, S. G. Swisher, W. L. Hofstetter, N. G. Ordonez, et al.
Extended Surgical Staging for Potentially Resectable Malignant Pleural Mesothelioma
Ann. Thorac. Surg., December 1, 2005; 80(6): 1988 - 1993.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
W. Weder, P. Kestenholz, C. Taverna, S. Bodis, D. Lardinois, M. Jerman, and R. A. Stahel
Neoadjuvant Chemotherapy Followed by Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma
J. Clin. Oncol., September 1, 2004; 22(17): 3451 - 3457.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J.E. Pilling, D.J. Stewart, A.E. Martin-Ucar, S. Muller, K.J. O'Byrne, and D.A. Waller
The case for routine cervical mediastinoscopy prior to radical surgery for malignant pleural mesothelioma
Eur. J. Cardiothorac. Surg., April 1, 2004; 25(4): 497 - 501.
[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 © 2003 by The Society of Thoracic Surgeons.