Author of

• 32374

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  P2.13 - Staging (ID 315)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Staging
  • Presentations: 1
  • Now Available
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 32381

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    P2.13-05 - Endobronchial Ultrasound for Mediastinal Restaging in Non-Small Cell Lung Cancer (Now Available) (ID 858)

    10:15 - 18:15  |  Author(s): Pere Serra Mitja
    • Abstract
    • Slides

    Background
    

    The adequate mediastinal restaging following neo-adjuvant therapy (NAT) in operable patients with non-small cell lung cancer (NSCLC) and N2 spread is crucial. Mediastinoscopy is the gold standard for mediastinal restanging, but endosonographic procedures are less invasive and can be an alternative. AIM: Evaluate the role of endobronchial ultrasound-guided transbronchial needle aspirate EBUS-TBNA in mediastinal the restaging of NSCLC.

    Method
    

    Prospective study with 32 patients with CPNCP N2 spread confirmed by TNBA-EBUS, collected from June 2010 to October 2018. These patients were subjected to neoadjuvant treatment (chemotherapy or radio-chemotherapy), subsequently were performed mediastinum restage with TNBA-EBUS. The negative cases were subjected to mediastinoscopy or thoracotomy.

    Result
    

    Of the 32 cases, the basal characteristics are detailed in table 1. Were analysed 229 lymph nodes, 42 of these were malignant (18%). TNBA-EBUS after neoadjuvant treatment showed persistence of N2 spread in 19 cases (52%). In negative cases (n=13; 41%) were performed mediastinoscopy (n=11) or surgery (n=1). After these procedures were confirmed mediastinal disease in 3 cases, 9 lymph nodes of 43 removed. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 86.4%, 100%, 100%, 72.7% and 90% respectively. There was recurrence of the disease in 15 cases (47%). We found a significant difference between recurrence and the type of neoadjuvant treatment (chemotherapy vs. radio-chemotherapy), p=0.047.

    Table 1.

    

    Conclusion
    

    TBNA-EBUS is an appropriate semi-invasive tool in mediastinal restage after neoadjuvant treatment, with high diagnostic accuracy. Nevertheless, in negative cases is still necessary support with invasive procedures.

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