Remediastinoscopy after induction chemotherapy in non-small cell lung cancer
Background. This study was undertaken to evaluate the technical feasibility and the sensitivity, specificity, and accuracy of remediastinoscopy in restaging N2 bronchogenic carcinoma treated with neoadjuvant chemotherapy. Methods. Patients presenting mediastinal lymph node involvement at mediastinos...
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| Veröffentlicht in: | The Annals of thoracic surgery 2000-08, Vol.70 (2), p.391-395 |
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| creator | Mateu-Navarro, Miquel Rami-Porta, Ramón Bastus-Piulats, Romà Cirera-Nogueras, Luis González-Pont, Guadalupe |
| description | Background. This study was undertaken to evaluate the technical feasibility and the sensitivity, specificity, and accuracy of remediastinoscopy in restaging N2 bronchogenic carcinoma treated with neoadjuvant chemotherapy.
Methods. Patients presenting mediastinal lymph node involvement at mediastinoscopy received three or four cycles of neoadjuvant chemotherapy with mitomycin, iphosphamide, and cisplatin or cisplatin and gemcitabine. If there was no disease progression, these patients underwent remediastinoscopy and, if no residual extracapsular involvement or N3 disease was found, a thoracotomy was then carried out.
Results. Twenty-four patients underwent remediastinoscopy. In 12 (50%) remediastinoscopy was positive. The 12 remaining patients were operated on and the tumors resected: 5 pneumonectomies and 7 lobectomies. Lymphadenectomy specimens showed residual disease in mediastinal lymph nodes in 5 patients (pN2) and hilar lymph nodes in 1 patient (pN1). The other 6 patients were free of nodal disease, and 4 of them presented no involvement at lung level either. The sensitivity, specificity, and accuracy of remediastinoscopy were 0.7, 1, and 0.8, respectively.
Conclusions. Remediastinoscopy is a technically feasible staging tool with high diagnostic accuracy that is useful in the selection of patients who can be served best by complete resection after neoadjuvant chemotherapy. |
| doi_str_mv | 10.1016/S0003-4975(00)01437-5 |
| format | Article |
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Methods. Patients presenting mediastinal lymph node involvement at mediastinoscopy received three or four cycles of neoadjuvant chemotherapy with mitomycin, iphosphamide, and cisplatin or cisplatin and gemcitabine. If there was no disease progression, these patients underwent remediastinoscopy and, if no residual extracapsular involvement or N3 disease was found, a thoracotomy was then carried out.
Results. Twenty-four patients underwent remediastinoscopy. In 12 (50%) remediastinoscopy was positive. The 12 remaining patients were operated on and the tumors resected: 5 pneumonectomies and 7 lobectomies. Lymphadenectomy specimens showed residual disease in mediastinal lymph nodes in 5 patients (pN2) and hilar lymph nodes in 1 patient (pN1). The other 6 patients were free of nodal disease, and 4 of them presented no involvement at lung level either. The sensitivity, specificity, and accuracy of remediastinoscopy were 0.7, 1, and 0.8, respectively.
Conclusions. Remediastinoscopy is a technically feasible staging tool with high diagnostic accuracy that is useful in the selection of patients who can be served best by complete resection after neoadjuvant chemotherapy.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(00)01437-5</identifier><identifier>PMID: 10969650</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Carcinoma, Bronchogenic - drug therapy ; Carcinoma, Bronchogenic - surgery ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - surgery ; Chemotherapy, Adjuvant ; Feasibility Studies ; Humans ; Lung Neoplasms - drug therapy ; Lung Neoplasms - surgery ; Male ; Mediastinoscopy ; Medical sciences ; Middle Aged ; Neoplasm Staging - methods ; Reoperation ; Sensitivity and Specificity ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the respiratory system</subject><ispartof>The Annals of thoracic surgery, 2000-08, Vol.70 (2), p.391-395</ispartof><rights>2000 The Society of Thoracic Surgeons</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-3f79322ba5922d45d07c19bf54d42b0636c801b451563b5504be35ca166a40743</citedby><cites>FETCH-LOGICAL-c472t-3f79322ba5922d45d07c19bf54d42b0636c801b451563b5504be35ca166a40743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-4975(00)01437-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1482834$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10969650$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mateu-Navarro, Miquel</creatorcontrib><creatorcontrib>Rami-Porta, Ramón</creatorcontrib><creatorcontrib>Bastus-Piulats, Romà</creatorcontrib><creatorcontrib>Cirera-Nogueras, Luis</creatorcontrib><creatorcontrib>González-Pont, Guadalupe</creatorcontrib><title>Remediastinoscopy after induction chemotherapy in non-small cell lung cancer</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. This study was undertaken to evaluate the technical feasibility and the sensitivity, specificity, and accuracy of remediastinoscopy in restaging N2 bronchogenic carcinoma treated with neoadjuvant chemotherapy.
Methods. Patients presenting mediastinal lymph node involvement at mediastinoscopy received three or four cycles of neoadjuvant chemotherapy with mitomycin, iphosphamide, and cisplatin or cisplatin and gemcitabine. If there was no disease progression, these patients underwent remediastinoscopy and, if no residual extracapsular involvement or N3 disease was found, a thoracotomy was then carried out.
Results. Twenty-four patients underwent remediastinoscopy. In 12 (50%) remediastinoscopy was positive. The 12 remaining patients were operated on and the tumors resected: 5 pneumonectomies and 7 lobectomies. Lymphadenectomy specimens showed residual disease in mediastinal lymph nodes in 5 patients (pN2) and hilar lymph nodes in 1 patient (pN1). The other 6 patients were free of nodal disease, and 4 of them presented no involvement at lung level either. The sensitivity, specificity, and accuracy of remediastinoscopy were 0.7, 1, and 0.8, respectively.
Conclusions. Remediastinoscopy is a technically feasible staging tool with high diagnostic accuracy that is useful in the selection of patients who can be served best by complete resection after neoadjuvant chemotherapy.</description><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Bronchogenic - drug therapy</subject><subject>Carcinoma, Bronchogenic - surgery</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Chemotherapy, Adjuvant</subject><subject>Feasibility Studies</subject><subject>Humans</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Mediastinoscopy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging - methods</subject><subject>Reoperation</subject><subject>Sensitivity and Specificity</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the respiratory system</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtKxDAUhoMoOo4-gtKFiC6qJ9dOVyLiDQYEL-uQpqlG2mRMWmHe3tQZ1J2bHML5zsmfD6EDDGcYsDh_AgCas7LgJwCngBktcr6BJphzkgvCy000-UF20G6M7-lKUnsb7WAoRSk4TND80XSmtir21vmo_WKZqaY3IbOuHnRvvcv0m-l8_2aCSk3rMuddHjvVtpk26WgH95pp5bQJe2irUW00--s6RS83189Xd_n84fb-6nKea1aQPqdNUVJCKsVLQmrGayg0LquGs5qRCgQVega4YhxzQSvOgVWGcq2wEIpBwegUHa_2LoL_GEzsZWfjGEY544coC0IIFQwnkK9AHXyMwTRyEWynwlJikKNG-a1Rjo4kgPzWKHmaO1w_MFRJz5-plbcEHK0BFbVqm5D-b-Mvx2ZkRsegFyvMJBuf1gQZtTVJVW2D0b2svf0nyReskY2q</recordid><startdate>20000801</startdate><enddate>20000801</enddate><creator>Mateu-Navarro, Miquel</creator><creator>Rami-Porta, Ramón</creator><creator>Bastus-Piulats, Romà</creator><creator>Cirera-Nogueras, Luis</creator><creator>González-Pont, Guadalupe</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000801</creationdate><title>Remediastinoscopy after induction chemotherapy in non-small cell lung cancer</title><author>Mateu-Navarro, Miquel ; Rami-Porta, Ramón ; Bastus-Piulats, Romà ; Cirera-Nogueras, Luis ; González-Pont, Guadalupe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-3f79322ba5922d45d07c19bf54d42b0636c801b451563b5504be35ca166a40743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Bronchogenic - drug therapy</topic><topic>Carcinoma, Bronchogenic - surgery</topic><topic>Carcinoma, Non-Small-Cell Lung - drug therapy</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Chemotherapy, Adjuvant</topic><topic>Feasibility Studies</topic><topic>Humans</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Mediastinoscopy</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging - methods</topic><topic>Reoperation</topic><topic>Sensitivity and Specificity</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the respiratory system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mateu-Navarro, Miquel</creatorcontrib><creatorcontrib>Rami-Porta, Ramón</creatorcontrib><creatorcontrib>Bastus-Piulats, Romà</creatorcontrib><creatorcontrib>Cirera-Nogueras, Luis</creatorcontrib><creatorcontrib>González-Pont, Guadalupe</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mateu-Navarro, Miquel</au><au>Rami-Porta, Ramón</au><au>Bastus-Piulats, Romà</au><au>Cirera-Nogueras, Luis</au><au>González-Pont, Guadalupe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Remediastinoscopy after induction chemotherapy in non-small cell lung cancer</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2000-08-01</date><risdate>2000</risdate><volume>70</volume><issue>2</issue><spage>391</spage><epage>395</epage><pages>391-395</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. This study was undertaken to evaluate the technical feasibility and the sensitivity, specificity, and accuracy of remediastinoscopy in restaging N2 bronchogenic carcinoma treated with neoadjuvant chemotherapy.
Methods. Patients presenting mediastinal lymph node involvement at mediastinoscopy received three or four cycles of neoadjuvant chemotherapy with mitomycin, iphosphamide, and cisplatin or cisplatin and gemcitabine. If there was no disease progression, these patients underwent remediastinoscopy and, if no residual extracapsular involvement or N3 disease was found, a thoracotomy was then carried out.
Results. Twenty-four patients underwent remediastinoscopy. In 12 (50%) remediastinoscopy was positive. The 12 remaining patients were operated on and the tumors resected: 5 pneumonectomies and 7 lobectomies. Lymphadenectomy specimens showed residual disease in mediastinal lymph nodes in 5 patients (pN2) and hilar lymph nodes in 1 patient (pN1). The other 6 patients were free of nodal disease, and 4 of them presented no involvement at lung level either. The sensitivity, specificity, and accuracy of remediastinoscopy were 0.7, 1, and 0.8, respectively.
Conclusions. Remediastinoscopy is a technically feasible staging tool with high diagnostic accuracy that is useful in the selection of patients who can be served best by complete resection after neoadjuvant chemotherapy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10969650</pmid><doi>10.1016/S0003-4975(00)01437-5</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Carcinoma, Bronchogenic - drug therapy Carcinoma, Bronchogenic - surgery Carcinoma, Non-Small-Cell Lung - drug therapy Carcinoma, Non-Small-Cell Lung - surgery Chemotherapy, Adjuvant Feasibility Studies Humans Lung Neoplasms - drug therapy Lung Neoplasms - surgery Male Mediastinoscopy Medical sciences Middle Aged Neoplasm Staging - methods Reoperation Sensitivity and Specificity Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the respiratory system |
| title | Remediastinoscopy after induction chemotherapy in non-small cell lung cancer |
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