Virtual Library
Start Your Search
Weizhe Huang
Author of
-
+
MA13 - Interventional Pulmonology (ID 914)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 10:30 - 12:00, Room 206 AC
-
+
MA13.06 - Endosonography with Lymph Nodes Sampling for Restaging the Mediastinum in Lung Cancer: A Systematic Review and Pooled-Data Analysis (ID 11918)
11:05 - 11:10 | Author(s): Weizhe Huang
- Abstract
- Presentation
Background
Mediastinal restaging after induction treatment is still a difficult and controversial issue. We aimed to investigate the diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for restaging the mediastinum after induction treatment in patients with lung cancer.
a9ded1e5ce5d75814730bb4caaf49419 Method
Embase and PubMed databases were searched from conception to July 2017. Data from relevant studies were analyzed to assess sensitivity and specificity of EBUS-TBNA and EUS-FNA, and to fit the Hierarchical Summary Receiver-Operating Characteristic curves.
4c3880bb027f159e801041b1021e88e8 Result
A total of nine studies consisting of 542 patients fulfilled the inclusion criteria. All patients were restaged by EBUS-TBNA, EUS-FNA or both. Negative results were confirmed by subsequent surgical approaches. There were no complications reported during any endosonography approaches reviewed. The pooled sensitivities of EBUS-TBNA and EUS-FNA were 66%(95% CI, 60%-72%) and 73%(95% CI, 52%-87%), respectively; and specificities were 100%(95% CI, 98%-100%) and 99%(95% CI, 90%-100%), respectively. The area under the HSROC curves(AUC) were 0.84(95% CI, 0.81-0.87) for EBUS-TBNA and 0.99(95% CI, 0.98-1) for EUS-FNA. Moreover, for patients who received chemotherapy alone, the pooled sensitivity of endosonography with lymph node sampling for restaging was 69% (95% CI, 63%-75%), and specificity was 100% (95% CI, 97%-100%); and for patients who received chemoradiotherapy, the results seemed similar with sensitivity of 65% (95% CI, 50%-78%) and specificity of 100% (95% CI, 96%-100%).
Variables
No. of patients
Pooled sensitivity (95% CI)
Pooled specificity (95% CI)
Negative Likelihood Ratio
AUC
In all mediastinal stations
Overall
543
0.70 (0.65-0.75)
1.00 (0.98-1.00)
0.30 (0.21-0.43)
0.93 (0.91-0.95)
EBUS-TBNA
424
0.66 (0.60-0.72)
1.00 (0.98-1.00)
0.38 (0.26-0.54)
0.84 (0.81-0.87)
EUS-FNA
226
0.73 (0.52-0.87)
0.99 (0.90-1.00)
0.27 (0.14-0.53)
0.99 (0.90-1.00)
Combine
106
0.67 (0.53–0.79)
0.96 (0.86–0.99)
N/A
0.81 (0.73–0.87)
Subgroup analysis
Chemo alone
365
0.69 (0.63-0.75)
1.00 (0.97-1.00)
0.35 (0.26-0.48)
0.90 (0.88-0.94)
Chemo radiotherapy
130
0.65 (0.50-0.78)
1.00 (0.96-1.00)
0.25 (0.06-1.02)
0.97 (0.95-0.98)
If negative Likelihood Ratio(LR-) is smaller: essentially a definite diagnosis when negative result.
8eea62084ca7e541d918e823422bd82e Conclusion
Endosonography with lymph node sampling is an accurate and safe technique for mediastinal restaging of lung cancer. For nondiagnostic results, a further more invasive approach should be thoroughly considered.
6f8b794f3246b0c1e1780bb4d4d5dc53Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
