Endosonography with lymph node sampling for restaging the mediastinum in lung cancer: A systematic review and pooled data analysis.
Adult
Aged
Aged, 80 and over
Bronchoscopy
Chemotherapy, Adjuvant
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Female
Humans
Lung Neoplasms
/ pathology
Lymph Node Excision
Lymph Nodes
/ pathology
Lymphatic Metastasis
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
/ methods
Pneumonectomy
Predictive Value of Tests
Reproducibility of Results
Young Adult
EBUS
EUS
fine-needle aspiration
lung cancer
mediastinal restaging
Journal
The Journal of thoracic and cardiovascular surgery
ISSN: 1097-685X
Titre abrégé: J Thorac Cardiovasc Surg
Pays: United States
ID NLM: 0376343
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
19
01
2019
revised:
17
07
2019
accepted:
17
07
2019
pubmed:
9
10
2019
medline:
24
3
2020
entrez:
9
10
2019
Statut:
ppublish
Résumé
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 and endoscopic ultrasound-guided fine-needle aspiration for restaging the mediastinum after induction treatment in patients with lung cancer. Embase and PubMed databases were searched from conception to March 2019. Data from relevant studies were analyzed to assess sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration, and to fit the hierarchical summary receiver operating characteristic curves. A total of 10 studies consisting of 558 patients fulfilled the inclusion criteria. All patients were restaged by endobronchial ultrasound-guided transbronchial needle aspiration, endoscopic ultrasound-guided fine-needle aspiration, or both. Negative results were confirmed by subsequent surgical approaches. There were no complications reported during any endosonography approaches reviewed. The pooled sensitivities of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration were 65% (95% confidence interval [CI], 52-76) and 73% (95% CI, 52-87), respectively, and specificities were 99% (95% CI, 78-100) and 99% (95% CI, 90-100), respectively. The area under the hierarchical summary receiver operating characteristic curves were 0.85 (95% CI, 0.81-0.88) for endobronchial ultrasound-guided transbronchial needle aspiration and 0.99 (95% CI, 0.98-1) for endoscopic ultrasound-guided fine-needle aspiration. Moreover, for patients who received chemotherapy alone, the pooled sensitivity of endosonography with lymph node sampling for restaging was 66% (95% CI, 56-75), and specificity was 100% (95% CI, 34-100); for patients who received chemoradiotherapy, the results seemed similar with a sensitivity of 77% (95% CI, 47-92) and specificity of 99% (95% CI, 48-100). Endosonography with lymph node sampling is an accurate and safe technique for mediastinal restaging of lung cancer.
Sections du résumé
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 and endoscopic ultrasound-guided fine-needle aspiration for restaging the mediastinum after induction treatment in patients with lung cancer.
METHODS
Embase and PubMed databases were searched from conception to March 2019. Data from relevant studies were analyzed to assess sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration, and to fit the hierarchical summary receiver operating characteristic curves.
RESULTS
A total of 10 studies consisting of 558 patients fulfilled the inclusion criteria. All patients were restaged by endobronchial ultrasound-guided transbronchial needle aspiration, endoscopic ultrasound-guided fine-needle aspiration, or both. Negative results were confirmed by subsequent surgical approaches. There were no complications reported during any endosonography approaches reviewed. The pooled sensitivities of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration were 65% (95% confidence interval [CI], 52-76) and 73% (95% CI, 52-87), respectively, and specificities were 99% (95% CI, 78-100) and 99% (95% CI, 90-100), respectively. The area under the hierarchical summary receiver operating characteristic curves were 0.85 (95% CI, 0.81-0.88) for endobronchial ultrasound-guided transbronchial needle aspiration and 0.99 (95% CI, 0.98-1) for endoscopic ultrasound-guided fine-needle aspiration. Moreover, for patients who received chemotherapy alone, the pooled sensitivity of endosonography with lymph node sampling for restaging was 66% (95% CI, 56-75), and specificity was 100% (95% CI, 34-100); for patients who received chemoradiotherapy, the results seemed similar with a sensitivity of 77% (95% CI, 47-92) and specificity of 99% (95% CI, 48-100).
CONCLUSIONS
Endosonography with lymph node sampling is an accurate and safe technique for mediastinal restaging of lung cancer.
Identifiants
pubmed: 31590952
pii: S0022-5223(19)31649-6
doi: 10.1016/j.jtcvs.2019.07.095
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Pagination
1099-1108.e5Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.