Progress of Preoperative Mediastinal Lymph Node Staging for Non-small Cell Lung Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANRen-an , YINXun-liang ,  WEIYu-cheng

Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266000 Shandong, P. R. China;

Corresponding?author：

WEIYu-cheng, Email: weiyuchengchest@163.com

Keywords：

Lung cancer; Mediastinum; Lymph node; Staging

DOI：

10.7507/1007-4848.20150175

Video：

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Preoperative mediastinal lymph node staging for non-small cell lung cancer (NSCLC) can be divided into non-invasive imaging techniques staging and invasive surgery techniques staging . Noninvasive imaging techniques are not sufficiently reliable in many situations. Computed tomography (CT) has been used as a routine inspection due to the anatomical images it provides. Magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) have not been widely applied. As the most accurate technique of noninvasive staging, positron emission tomographycomputed tomography (PET-CT) still has a higher rate of false negative. Invasive staging technique is safe and effective in mediastinal lymph node staging. Mediastinoscopy is the gold standard for invasive mediastinal staging till today. Endoscopic ultrasound-needle aspiration techniques and video-assisted thoracoscopic surgery (VATS) are also safe and effective. Invasive staging technique is the first choice of the re-staging in patients after induction therapy.

Citation： WANRen-an, YINXun-liang, WEIYu-cheng. Progress of Preoperative Mediastinal Lymph Node Staging for Non-small Cell Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(7): 691-695. doi: 10.7507/1007-4848.20150175 Copy

1.	Imai K, Minamiya Y, Saito H, et al. Diagnostic imaging in the preoperative management of lung cancer. Surgery Today, 2013, 44(7):1197-1206.
2.	Silvestri GA, Gould MK, Margolis ML, et al. Noninvasive staging of non-small cell lung cancer:ACCP evidenced-based clinical practice guidelines (2nd edition). Chest, 2007, 132:178S-201S.
3.	Kudo S, Imai K, Ishiyama K, et al. New CT criteria for nodal staging in non-small cell lung cancer. Clinical Imaging, 2014, 38(4):448-453.
4.	De Leyn P, Dooms C, Kuzdzal J, et al. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardio-Thorac Surg, 2014, 45(5):787-798.
5.	馬海波, 丁志丹, 曲戈, 等. 非小細胞肺癌隆突下淋巴結轉移與臨床病理特征的關系. 中國胸心血管外科臨床雜志, 2013, 20(1):70-73.
6.	Xue J, Zheng J, Guo H, et al. Predictive value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography compared to postoperative pathological findings for patients with non-small-cell lung cancer. Mol Clin Oncol, 2015, 3(1):109-114.
7.	Revel MP, Carette MF, Torrent M, et al. Diagnosis and standardized report for non-small cell lung cancer. Diagn Interv Imaging, 2014, 95(7-8):727-738.
8.	Schmidt-Hansen M, Baldwin DR, Hasler E, et al. PET-CT for assessing mediastinal lymph node involvement in patients with suspected resectable non-small cell lung cancer. Cochrane Database Syst Rev. 2014, 11:CD009519.
9.	Al-Sarraf N, Aziz R, Doddakula K, et al. Factors causing inaccurate staging of mediastinal nodal involvement in non-small cell lung cancer patients staged by positron emission tomography. Interact Cardiovasc Thorac Surg, 2007, 6(3):350-353.
10.	Xu N, Wang M, Zhu Z, et al. Integrated positron emission tomography and computed tomography in preoperative lymph node staging of non-small cell lung cancer. Chin Med J (Engl), 2014, 127(4):607-613.
11.	Mennini ML, Catalano C, Del Monte M, et al. Computed tomography and magnetic resonance imaging of the thoracic lymphatic system. Thoracic Surgery Clinics, 2012, 22(2):155-160.
12.	Abdel Razek AA, Soliman NY, Elkhamary S, et al. Role of diffusionweighted MR imaging in cervical lymphadenopathy. Eur Radiol, 2006, 16(7):1468-1477.
13.	陳愛萍, 李惠民, 于紅, 等. 表觀擴散系數與非小細胞肺癌病理基礎初探. 磁共振成像, 2014, 5(1):40-44.
14.	Kwee TC, Takahara T, Ochiai R, et al. Complementary roles of whole-body diffusion-weighted MRI and 18F-FDG PET:the state of the art and potential applications. J Nucl Med, 2010, 51(10):1549-1558.
15.	Desprechins B, Stadnik T, Koerts G, et al. Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses.AJNR Am J Neuroradiol, 1999, 20(7):1252-1257.
16.	Usuda K, Sagawa M, Motono N, et al. Advantages of diffusionweighted imaging over positron emission tomography-computed tomography in assessment of hilar and mediastinal lymph node in lung cancer. Ann Surg Oncol, 2013, 20(5):1676-1683.
17.	Carlens E. Mediastinoscopy:a method for inspection and tissue biopsy in the superior mediastinum. Dis Chest, 1959, 36:343-352.
18.	Detterbeck FC, Jantz MA, Wallace M, et al. Invasive mediastinal staging of lung cancer:ACCP evidence-based clinical practice guidelines (2nd edition). Chest, 2007, 132:202S-220S.
19.	Chen C, Zhou YM. Extended Mediastinoscopic Examination at the Right Hilum. The Annals of Thoracic Surgery, 2008, 86(5):1704-1706.
20.	Howington JA. The role of VATS for staging and diagnosis in patients with non-small cell lung cancer. Semin Thorac Cardiovasc Surg, 2007, 19(3):212-216.
21.	Inzirillo F, Giorgetta C, Ravalli E, et al. Videomediastinoscopy:a ten year experience on lung cancer stadiation and non-diagnosed mediastinal lymphoadenopathy. Chirurgia (Bucur), 2014, 109(4):451-454.
22.	毛鋒, 張良, 蔡明輝, 等. 縱隔鏡在肺癌鑒別診斷和術前分期中的應用價值. 中國肺癌雜志, 2014, 17(2):171-174.
23.	Wei B, Bryant AS, Minnich DJ, et al. The safety and efficacy of mediastinoscopy when performed by general thoracic surgeons. Ann Thorac Surg, 2014, 97(6):1878-1884.
24.	邵豐, 蘇宜江, 許棟生, 等. 電視縱隔鏡手術診治胸部疾病36例. 中國胸心血管外科臨床雜志, 2009, 16(1):76-78.
25.	Leschber G, Holinka G, Linder A. Video-assisted mediastinoscopic lymphadenectomy (VAMLA)——a method for systematic mediastinal lymphnode dissection. Eur J Cardiothorac Surg, 2003, 24(2):192-195.
26.	Witte B, Wolf M, Huertgen M, et al. Video-assisted mediastinoscopic surgery:clinical feasibility and accuracy of mediastinal lymph node staging. Ann Thorac Surg, 2006, 82(5):1821-1827.
27.	Hurtgen M, Friedel G, Toomes H, et al. Radical video-assistedmediastinoscopic lymphadenectomy (VAMLA)——technique and first results. Eur J Cardiothorac Surg, 2002, 21(2):348-3451.
28.	Zielinski M, Szlubowski A, Ko?odziej M, et al. Comparison of endobronchial ultrasound and/or endoesophageal ultrasound with transcervical extended mediastinal lymphadenectomy for staging and restaging of non-small-cell lung cancer. J Thorac Oncol, 2013, 8(5):630-636.
29.	Zielinski M. Video-assisted mediastinoscopic lymphadenectomy and transcervical extended mediastinal lymphadenectomy. Thorac Surg Clin, 2012, 22(2):219-225.
30.	Colella S, Vilmann P, Konge L, et al. Endoscopic ultrasound in the diagnosis and staging of lung cancer. Endosc Ultrasound, 2014, 3(4):205-212.
31.	Schuder G, Isringhaus h, Kubale B, et al. Endoscopic ultrasonography of the mediastinum in the diagnosis of bronchial carcinoma. Thorac Cardiovasc Surg, 1991, 39(5):299-303.
32.	Wiersema MJ, Kochman ML, Chak A, et al. Real-time endoscopic ultrasound-guided fine-needle aspiration of a mediastinal lymph node. Gastrointest Endosc, 1993, 39(3):429-431.
33.	VanderLaan PA, Wang HH, Majid A, et al. Endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA):an overview and update for the cytopathologist. Cancer Cytopathol, 2014, 122(8):561-576.
34.	Yasufuku K, Chhajed PN, Sekine Y, et al. Endobronchial ultrasound using a new convex probe:a preliminary study on surgically resected specimens. Oncol Rep, 2004, 11(2):293-296.
35.	Guarize J, Pardolesi A, Donghi S, et al. Endobronchial ultrasound for mediastinal staging in lung cancer patients. Multimed Man Cardiothorac Surg, 2014, 2014. pii:mmu021. doi:10.1093/mmcts/mmu021.
36.	Zhang R, Ying K, Shi L, et al. Combined endobronchial and endoscopic ultrasound-guided fine needle aspiration for mediastinal lymph node staging of lung cancer:A meta-analysis. Eur J. Cancer, 2013, 49(8):1860-1867.
37.	Oki M, Saka H, Ando M, et al. Endoscopic ultrasound-guided fine needle aspiration and endobronchial ultrasound-guidedtransbronchial needle aspiration:Are two better than one in mediastinal staging of non-small cell lung cancer? J Thorac Cardiovasc Surg, 2014, 148(4):1169-1177.
38.	Varela-Lema L, Fernández-Villar A, Ruano-Ravina A. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration:a systematic review. Eur Respir J, 2009, 33(5):1156-164.
39.	Silvestri GA, Gonzalez AV, Jantz MA, et al. Methods for staging non-small cell lung cancer:Diagnosis and management of lung cancer, 3rd ed:American College of Chest Physicians evidencebased clinical practice guidelines. Chest, 2013, 143(5 Suppl):e211S-250S.
40.	趙輝, 王俊, 李劍鋒, 等. 支氣管內超聲引導針吸活檢術在胸部疾病中的臨床應用價值. 中國胸心血管外科臨床雜志, 2010, 17(5):353-356.
41.	Hatzinger M, A H?cker, S Langbein, et al. Hans-Christian Jacobaeus (1879-1937). Urologe A, 2006, 45(9):1184-1186.
42.	劉倫旭. 開胸手術將逐漸"升級"為胸腔鏡微創手術的補充. 中國胸心血管外科臨床雜志, 2012, 19(2):109-112.
43.	Herth FJ, Annema JT, Eberhardt R, et al. Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer. J Clin Oncol, 2008, 26(20):3346-3350.
44.	TNasir BS, Bryant AS, Minnich DJ, et al. The efficacy of restaging endobronchial ultrasound in patients with non-small cell lung cancer after preoperative therapy. Ann Thorac Surg, 2014, 98(3):1008-1012.
45.	Jaklitsch MT, Gu L, Demmy T, et al. Prospective phase II trial of preresection thoracoscopic mediastinal restaging after neoadjuvant therapy for IIIA (N2) non-small cell lung cancer:results of CALGB Protocol 39803. J Thorac Cardiovasc Surg, 2013, 146(1):9-16.

1. Imai K, Minamiya Y, Saito H, et al. Diagnostic imaging in the preoperative management of lung cancer. Surgery Today, 2013, 44(7):1197-1206.
2. Silvestri GA, Gould MK, Margolis ML, et al. Noninvasive staging of non-small cell lung cancer:ACCP evidenced-based clinical practice guidelines (2nd edition). Chest, 2007, 132:178S-201S.
3. Kudo S, Imai K, Ishiyama K, et al. New CT criteria for nodal staging in non-small cell lung cancer. Clinical Imaging, 2014, 38(4):448-453.
4. De Leyn P, Dooms C, Kuzdzal J, et al. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardio-Thorac Surg, 2014, 45(5):787-798.
5. 馬海波, 丁志丹, 曲戈, 等. 非小細胞肺癌隆突下淋巴結轉移與臨床病理特征的關系. 中國胸心血管外科臨床雜志, 2013, 20(1):70-73.
6. Xue J, Zheng J, Guo H, et al. Predictive value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography compared to postoperative pathological findings for patients with non-small-cell lung cancer. Mol Clin Oncol, 2015, 3(1):109-114.
7. Revel MP, Carette MF, Torrent M, et al. Diagnosis and standardized report for non-small cell lung cancer. Diagn Interv Imaging, 2014, 95(7-8):727-738.
8. Schmidt-Hansen M, Baldwin DR, Hasler E, et al. PET-CT for assessing mediastinal lymph node involvement in patients with suspected resectable non-small cell lung cancer. Cochrane Database Syst Rev. 2014, 11:CD009519.
9. Al-Sarraf N, Aziz R, Doddakula K, et al. Factors causing inaccurate staging of mediastinal nodal involvement in non-small cell lung cancer patients staged by positron emission tomography. Interact Cardiovasc Thorac Surg, 2007, 6(3):350-353.
10. Xu N, Wang M, Zhu Z, et al. Integrated positron emission tomography and computed tomography in preoperative lymph node staging of non-small cell lung cancer. Chin Med J (Engl), 2014, 127(4):607-613.
11. Mennini ML, Catalano C, Del Monte M, et al. Computed tomography and magnetic resonance imaging of the thoracic lymphatic system. Thoracic Surgery Clinics, 2012, 22(2):155-160.
12. Abdel Razek AA, Soliman NY, Elkhamary S, et al. Role of diffusionweighted MR imaging in cervical lymphadenopathy. Eur Radiol, 2006, 16(7):1468-1477.
13. 陳愛萍, 李惠民, 于紅, 等. 表觀擴散系數與非小細胞肺癌病理基礎初探. 磁共振成像, 2014, 5(1):40-44.
14. Kwee TC, Takahara T, Ochiai R, et al. Complementary roles of whole-body diffusion-weighted MRI and 18F-FDG PET:the state of the art and potential applications. J Nucl Med, 2010, 51(10):1549-1558.
15. Desprechins B, Stadnik T, Koerts G, et al. Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses.AJNR Am J Neuroradiol, 1999, 20(7):1252-1257.
16. Usuda K, Sagawa M, Motono N, et al. Advantages of diffusionweighted imaging over positron emission tomography-computed tomography in assessment of hilar and mediastinal lymph node in lung cancer. Ann Surg Oncol, 2013, 20(5):1676-1683.
17. Carlens E. Mediastinoscopy:a method for inspection and tissue biopsy in the superior mediastinum. Dis Chest, 1959, 36:343-352.
18. Detterbeck FC, Jantz MA, Wallace M, et al. Invasive mediastinal staging of lung cancer:ACCP evidence-based clinical practice guidelines (2nd edition). Chest, 2007, 132:202S-220S.
19. Chen C, Zhou YM. Extended Mediastinoscopic Examination at the Right Hilum. The Annals of Thoracic Surgery, 2008, 86(5):1704-1706.
20. Howington JA. The role of VATS for staging and diagnosis in patients with non-small cell lung cancer. Semin Thorac Cardiovasc Surg, 2007, 19(3):212-216.
21. Inzirillo F, Giorgetta C, Ravalli E, et al. Videomediastinoscopy:a ten year experience on lung cancer stadiation and non-diagnosed mediastinal lymphoadenopathy. Chirurgia (Bucur), 2014, 109(4):451-454.
22. 毛鋒, 張良, 蔡明輝, 等. 縱隔鏡在肺癌鑒別診斷和術前分期中的應用價值. 中國肺癌雜志, 2014, 17(2):171-174.
23. Wei B, Bryant AS, Minnich DJ, et al. The safety and efficacy of mediastinoscopy when performed by general thoracic surgeons. Ann Thorac Surg, 2014, 97(6):1878-1884.
24. 邵豐, 蘇宜江, 許棟生, 等. 電視縱隔鏡手術診治胸部疾病36例. 中國胸心血管外科臨床雜志, 2009, 16(1):76-78.
25. Leschber G, Holinka G, Linder A. Video-assisted mediastinoscopic lymphadenectomy (VAMLA)——a method for systematic mediastinal lymphnode dissection. Eur J Cardiothorac Surg, 2003, 24(2):192-195.
26. Witte B, Wolf M, Huertgen M, et al. Video-assisted mediastinoscopic surgery:clinical feasibility and accuracy of mediastinal lymph node staging. Ann Thorac Surg, 2006, 82(5):1821-1827.
27. Hurtgen M, Friedel G, Toomes H, et al. Radical video-assistedmediastinoscopic lymphadenectomy (VAMLA)——technique and first results. Eur J Cardiothorac Surg, 2002, 21(2):348-3451.
28. Zielinski M, Szlubowski A, Ko?odziej M, et al. Comparison of endobronchial ultrasound and/or endoesophageal ultrasound with transcervical extended mediastinal lymphadenectomy for staging and restaging of non-small-cell lung cancer. J Thorac Oncol, 2013, 8(5):630-636.
29. Zielinski M. Video-assisted mediastinoscopic lymphadenectomy and transcervical extended mediastinal lymphadenectomy. Thorac Surg Clin, 2012, 22(2):219-225.
30. Colella S, Vilmann P, Konge L, et al. Endoscopic ultrasound in the diagnosis and staging of lung cancer. Endosc Ultrasound, 2014, 3(4):205-212.
31. Schuder G, Isringhaus h, Kubale B, et al. Endoscopic ultrasonography of the mediastinum in the diagnosis of bronchial carcinoma. Thorac Cardiovasc Surg, 1991, 39(5):299-303.
32. Wiersema MJ, Kochman ML, Chak A, et al. Real-time endoscopic ultrasound-guided fine-needle aspiration of a mediastinal lymph node. Gastrointest Endosc, 1993, 39(3):429-431.
33. VanderLaan PA, Wang HH, Majid A, et al. Endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA):an overview and update for the cytopathologist. Cancer Cytopathol, 2014, 122(8):561-576.
34. Yasufuku K, Chhajed PN, Sekine Y, et al. Endobronchial ultrasound using a new convex probe:a preliminary study on surgically resected specimens. Oncol Rep, 2004, 11(2):293-296.
35. Guarize J, Pardolesi A, Donghi S, et al. Endobronchial ultrasound for mediastinal staging in lung cancer patients. Multimed Man Cardiothorac Surg, 2014, 2014. pii:mmu021. doi:10.1093/mmcts/mmu021.
36. Zhang R, Ying K, Shi L, et al. Combined endobronchial and endoscopic ultrasound-guided fine needle aspiration for mediastinal lymph node staging of lung cancer:A meta-analysis. Eur J. Cancer, 2013, 49(8):1860-1867.
37. Oki M, Saka H, Ando M, et al. Endoscopic ultrasound-guided fine needle aspiration and endobronchial ultrasound-guidedtransbronchial needle aspiration:Are two better than one in mediastinal staging of non-small cell lung cancer? J Thorac Cardiovasc Surg, 2014, 148(4):1169-1177.
38. Varela-Lema L, Fernández-Villar A, Ruano-Ravina A. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration:a systematic review. Eur Respir J, 2009, 33(5):1156-164.
39. Silvestri GA, Gonzalez AV, Jantz MA, et al. Methods for staging non-small cell lung cancer:Diagnosis and management of lung cancer, 3rd ed:American College of Chest Physicians evidencebased clinical practice guidelines. Chest, 2013, 143(5 Suppl):e211S-250S.
40. 趙輝, 王俊, 李劍鋒, 等. 支氣管內超聲引導針吸活檢術在胸部疾病中的臨床應用價值. 中國胸心血管外科臨床雜志, 2010, 17(5):353-356.
41. Hatzinger M, A H?cker, S Langbein, et al. Hans-Christian Jacobaeus (1879-1937). Urologe A, 2006, 45(9):1184-1186.
42. 劉倫旭. 開胸手術將逐漸"升級"為胸腔鏡微創手術的補充. 中國胸心血管外科臨床雜志, 2012, 19(2):109-112.
43. Herth FJ, Annema JT, Eberhardt R, et al. Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer. J Clin Oncol, 2008, 26(20):3346-3350.
44. TNasir BS, Bryant AS, Minnich DJ, et al. The efficacy of restaging endobronchial ultrasound in patients with non-small cell lung cancer after preoperative therapy. Ann Thorac Surg, 2014, 98(3):1008-1012.
45. Jaklitsch MT, Gu L, Demmy T, et al. Prospective phase II trial of preresection thoracoscopic mediastinal restaging after neoadjuvant therapy for IIIA (N2) non-small cell lung cancer:results of CALGB Protocol 39803. J Thorac Cardiovasc Surg, 2013, 146(1):9-16.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Progress of Preoperative Mediastinal Lymph Node Staging for Non-small Cell Lung Cancer

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