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EBUS vs. Mediastinoscopy for Initial Pathologic Mediastinal Staging in NSCLC

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Difficult Decisions in Thoracic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

Abstract

Accurate lung cancer staging is essential for proper selection of treatment, estimation of prognosis and avoidance of unnecessary surgeries. This chapter summarizes the existing guidelines and the landmark articles for invasive techniques used for initial pathologic mediastinal staging of patients with lung cancer. Based on the currently available published literature, we recommend: (1) EBUS-TBNA over mediastinoscopy for pre-operative mediastinal staging because of its higher accuracy and better safety profile; (2) EBUS-TBNA over mediastinoscopy for patients with CT-PET normal mediastinum and primary tumor larger than 3 cm, central tumors or cN1 disease to detect occult N2/N3 disease; and (3) EBUS-TBNA for sampling hilar and interlobar N1 nodes for non-surgical patients evaluated for stereotactic body radiotherapy or those considered for neoadjuvant therapy in the presence of multiple N1 disease.

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Authors and Affiliations

  1. Interventional Pulmonology, Section of Pulmonary and Critical Care Medicine, The University of Chicago, Chicago, IL, USA

    Abhinav Agrawal & Septimiu Murgu

  2. Department of Medicine, Division of Pulmonary and Critical Care, University of Chicago, Chicago, IL, USA

    Abhinav Agrawal & Septimiu Murgu

Authors
  1. Abhinav Agrawal
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  2. Septimiu Murgu
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Correspondence to Septimiu Murgu .

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Editors and Affiliations

  1. Department of Surgery, University of Chicago, Chicago, IL, USA

    Mark K. Ferguson

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Agrawal, A., Murgu, S. (2020). EBUS vs. Mediastinoscopy for Initial Pathologic Mediastinal Staging in NSCLC. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-47404-1_6

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  • DOI: https://doi.org/10.1007/978-3-030-47404-1_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47403-4

  • Online ISBN: 978-3-030-47404-1

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