Commentary: Mediastinal restaging with endosonography —Encouraging results, but does it really matter?

It is universally accepted that endosonography, either endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) or endoscopic ultrasound with fine-needle aspiration biopsy (EUS-FNA), has become the gold standard technique, replacing surgical mediastinal staging (mediastinoscopy, mediastinotomy, video-assisted thoracoscopic surgery, video-assisted mediastinoscopic lymphadenectomy, transcervical extended mediastinal lymphadenectomy) as the first test of choice for staging the mediastinum in patients with non –small cell lung cancer (NSCLC).
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research

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CONCLUSIONS: Our study supports the use of this minimally invasive technique for paraesophageally locatedlung tumors and demonstrates that EUS-FNA is safe and has an excellent diagnostic yield. PMID: 31765444 [PubMed - in process]
Source: Medical Ultrasonography - Category: Radiology Tags: Med Ultrason Source Type: research
Introduction: The EBUS-TBNA is a minimally invasive technique widely used in the diagnosis, staging and immunohistochemistry analysis of lung cancer.1PDL-1 is a checkpoint on NSCLC that can be targeted with immunotherapy.2Routine PDL-1 testing was introduced at Oxford University Hospital NHS Foundation Trust (OUHFT) in 2017 and it is unclear if EBUS-TBNA provides adequate tissue for testing. In our current practice at the OUHFT, all NSCLC cases (Squamous Cell Lung Carcinoma and Lung Adenocarcinoma) identified on cytopathology are subsequently tested for PDL-1 tumour percentage score (TPS). The aim of this study was to see ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung cancer Source Type: research
Conclusion: The preliminary diagnoses (ROSE) are concordant with the final diagnoses in a high percentage. Consequently, clinical decisions based on the ROSE can be taken with confidence.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung cancer Source Type: research
Authors: Biswas A, Jantz MA, Mehta HJ PMID: 31737291 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
CONCLUSIONS: ROSE diagnosis has a high concordance with the final diagnosis. PMID: 31618415 [PubMed - as supplied by publisher]
Source: American Journal of Clinical Pathology - Category: Pathology Authors: Tags: Am J Clin Pathol Source Type: research
Conclusions: Occult LN MMs can be detected in EBUS-TBNA specimens obtained during staging examinations and are associated with poor clinical outcomes. If prospectively confirmed, these results have significant implications for EBUS-TBNA specimen analyses and possibly for the NSCLC staging paradigm. PMID: 31559073 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
We describe two patients with advanced non ‐small‐cell lung cancer (NSCLC), including one in whom the definitive diagnosis of pulmonary pleomorphic carcinoma (PPC) was made by histopathology of the resected tumour and another in whom the diagnosis of “favor adenocarcinoma containing sarcomatoid components” was made by tissue biopsy. Both were resistant to first line platinum‐based chemotherapy, but responded dramatically to second line nivolumab therapy. We present two cases of pulmonary pleomorphic carcinoma (PPC) treated with Nivolumab. A 57 ‐year‐old man presented with a 3.5‐cm mass in the left l...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
There is increasing awareness of the role of the tumor-draining lymph node (TDLN) as an early site of both immune activation and evasion by non-small cell lung cancers (NSCLC) 1,2. While there have been tremendous advances in our understanding of the dynamic process of immunoediting in the tumor microenvironment and its prognostic significance, less is known about changes in effector and regulatory mechanisms at the level of the TDLN 3 –7. There are several features of both the tumor and TDLN that attenuate effective immune activation, including defects in antigen presentation, induction of anergy in effector T cells...
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
Authors: Sakairi Y, Nakajima T, Yoshino I Abstract Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a low-invasive modality that shows excellent sensitivity, specificity, and accuracy in the diagnosis of nodal metastasis of lung cancer. Thus, EBUS-TBNA has become the first choice for nodal staging of non-small cell lung cancer and an alternative to mediastinoscopy, which had long been the gold standard. EBUS-TBNA can be utilized not only for initial cancer staging but also for staging after treatment or for diagnostic purposes, including molecular diagnostics. Adequate s...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
This study was performed in order to define the prevalence of mediastinal LN metastases discovered on combined endosonography by endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS) fine needle aspiration in patients with a radiologically normal mediastinum. This study consists of a retrospective, single-institution, tertiary care referral center review of a prospectively maintained database.
Source: Seminars in Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: THORACIC – Original Submission Source Type: research
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