Original articleGeneral thoracicEndobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Management of Previously Treated Lung Cancer
Section snippets
Patients and Methods
This single-center, retrospective study with prospective follow-up was approved by the Research Ethics Board of University Health Network, the University of Toronto. All EBUS-TBNA procedures performed at the Toronto General Hospital, University of Toronto between July 2008 and October 2010 were identified from our database. Age, sex, history of cancer before EBUS-TBNA, type of cancer, cancer stage, type of treatment, and follow-up information, including cancer recurrence, were collected from
Results
During the study period, 456 EBUS-TBNA procedures were performed in 450 patients. Patient characteristics and the indication of EBUS-TBNA are reported in Table 1. The leading indication of EBUS-TBNA in our institution was lung cancer staging, followed by the assessment of mediastinal/hilar lymphadenopathy. In 13 patients with a lung mass suspicious of cancer, EBUS-TBNA was done to obtain cytologic diagnosis because EBUS allowed visualization of centrally located lesions for biopsy.
Of 450
Comment
New mediastinal/hilar lymphadenopathy after primary therapy in patients with lung cancer is common, but it is still a challenge to reach a definitive diagnosis of mediastinal/hilar cancer recurrence with the current imaging modalities, including CT scan and PET scan. Those who underwent surgical resection of lung cancer are often not good candidates for surgical staging because they may have undergone mediastinal lymphadenectomy or mediastinoscopy at the time of their initial treatment. Repeat
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Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Diagnosis and Staging of Lung Cancer
2018, Clinics in Chest MedicineCitation Excerpt :In staging EBUS TBNA, lymph nodes are often small and need to be systematically sampled starting at the highest lymph node group (N3) and working back toward N1 node groups with the use of rapid on-site examination (ROSE).8 EBUS TBNA is also an important way to rebiopsy after neoadjuvant treatment or in the setting of relapse after therapy.4,9 EBUS TBNA is ideal for rebiopsy after progression for patients on endothelial growth factor receptor (EGFR) tyrosine kinase inhibitors to detect specific new mutations such as T790M.10
Recent advances in endobronchial ultrasound-guided transbronchial needle aspiration
2016, Respiratory InvestigationCitation Excerpt :When CT and/or PET show abnormalities within the mediastinum or the hilum (i.e., enlarged lymph nodes or fluorodeoxyglucose (FDG)-avid lymph nodes), tissue confirmation is oftentimes necessary to rule out reactive adenopathy vs. recurrence, because radiology findings alone are not reliable [20]. In our experience, EBUS-TBNA of radiologically abnormal mediastinal lymph nodes confirmed different histology compared to the original lung cancer; this was helpful for subsequent therapy [21]. The indication of invasive mediastinal staging in lung cancer depends on the stage and radiologic findings (e.g., CT, PET).
What is the yield of EBUS-TBNA for re-evaluation of previously treated non-small-cell lung cancer?
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