The Experts below are selected from a list of 7458 Experts worldwide ranked by ideXlab platform

Lin Zhou - One of the best experts on this subject based on the ideXlab platform.

  • combined endobronchial and endoscopic ultrasound guided fine needle aspiration for Mediastinal Lymph Node staging of lung cancer a meta analysis
    European Journal of Cancer, 2013
    Co-Authors: Ruifeng Zhang, Kejing Ying, Lianfeng Zhang, Lin Zhou
    Abstract:

    Abstract Study objectives This systematic review and meta-analysis was conducted to evaluate the accuracy of the combined endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) techniques and clarify its current role for the Mediastinal Lymph Node staging of lung cancer. Methods Medline, Web of Science, Elsevier and Ovid were searched to identify suitable studies up to 15th July 2012. Two investigators independently reviewed articles and extracted data. All EBUS-TBNA plus EUS-FNA studies for the Mediastinal Node staging of lung cancer were systematically reviewed. Sensitivity, specificity and other accuracy measures were pooled using random-effect models. Summary receiver operating characteristic curves were used to summarise overall test performance. Results Eight studies met our inclusion criteria. The estimated summary measures for quantitative analysis of EBUS-TBNA plus EUS-FNA for Mediastinal nodal staging of lung cancer were sensitivity, 0.86 (95% confidence interval [CI], 0.82–0.90); specificity, 1.00 (95% CI, 0.99–1.00); positive likelihood ratio, 51.77 (95% CI, 22.53–118.94); negative likelihood ratio, 0.15 (95% CI, 0.09–0.25); diagnostic odds ratio, 416.83 (95% CI, 140.08–1240.31); and area under the curve (AUC), 0.99. Conclusions The current evidence suggests that the combined technique is more sensitive than EBUS-TBNA or EUS-FNA alone. The diagnostic power of this combined technique is accurate. As an almost completely minimally-invasive examination, EUS-FNA plus EBUS-TBNA may replace more invasive methods for evaluating Mediastinal Node staging of lung cancer.

Buddhiwardhan Ojha - One of the best experts on this subject based on the ideXlab platform.

  • endoscopic ultrasound guided fine needle aspiration of Mediastinal Lymph Node in patients with suspected lung cancer after positron emission tomography and computed tomography scans
    The Annals of Thoracic Surgery, 2005
    Co-Authors: Mohamad A Eloubeidi, Robert J Cerfolio, Victor K Chen, Renee A Desmond, Sujath Syed, Buddhiwardhan Ojha
    Abstract:

    Background The treatment of patients with non-small cell lung cancer (NSCLC) depends on the stage. Positron emission and computed tomography (CT) scans can identify suspicious Lymph Nodes that require biopsy. We prospectively evaluated the yield and accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in sampling Mediastinal Lymph Nodes and compared its accuracy to that of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and CT in staging NSCLC. Methods A consecutive series of patients with suspicious Nodes on PET or CT scan in the posterior Mediastinal Lymph Node stations (#5, 7, 8, or 9) were prospectively evaluated by EUS-FNA. The reference standard included thoracotomy with complete Lymphadenectomy in patients with lung cancer or if EUS-FNA was benign, repeat clinical imaging, or long-term follow-up. Results There were 104 patients (63 men) with 125 lesions (117 Lymph Nodes, 8 left adrenal glands) who underwent EUS-FNA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EUS-FNA were 92.5%, 100%, 100%, 94%, and 97%, respectively. EUS-FNA was more accurate and had a higher positive predictive value than the PET or CT ( p Conclusions EUS-FNA is a safe, accurate, and minimally invasive technique that improves the staging of patients with NSCLC. It is more accurate and has a higher predictive value than either the PET scan or CT scan for posterior Mediastinal Lymph Nodes.

Li Zhang - One of the best experts on this subject based on the ideXlab platform.

Xin Wang - One of the best experts on this subject based on the ideXlab platform.

  • the incidence and distribution of Mediastinal Lymph Node metastasis and its impact on survival in patients with non small cell lung cancers 3 cm or less data from 2292 cases
    European Journal of Cardio-Thoracic Surgery, 2019
    Co-Authors: Mu Zi Yang, Xin Wang, Run Bin Liang, Jie Yang, Hao Long, Peng Lin, Tiehua Rong, Xue Hou, Ren Chun Lai, Haoxian Yang
    Abstract:

    OBJECTIVES Our goal was to investigate the incidence and distribution of Mediastinal Lymph Node metastases (MLNM) in non-small-cell lung cancers (NSCLC) 3 cm or less, with the purpose of guiding Mediastinal Lymph Node dissection. METHODS A total of 2292 cases seen between January 2001 and December 2014 were included. These patients were grouped according to the lobes with the primary tumours. The incidence and distribution of pathological MLNM were compared among the groups. The impact of MLNM on overall survival was also compared. RESULTS The most common Mediastinal metastatic sites for different primary tumour lobes were as follows: right upper lobe, 17.7% (87/492) for level 4R; right middle lobe, 14.9% (28/188) for level 7; right lower lobe, 19.8% (82/414) for level 7; left upper lobe, 18.2% (96/528) for level 5; and left lower lobe, 16.6% (42/253) for level 7. For patients with tumours in the upper lobe, the median survival time was 32 months for those with MLNM in the subcarinal zone or lower zone compared with 83 months for those with MLNM only in the upper zone (P < 0.01). When the tumours were 1 cm or less, the incidence of MLNM to the lower zone for upper lobe tumours and of MLNM to the upper zone for lower lobe tumours was zero. CONCLUSIONS Different primary NSCLC lobe locations have a different propensity to be sites of MLNM for those tumours that are 3 cm or less. For tumours no larger than 1 cm, a lower zone Mediastinal Lymph Node dissection might be unnecessary for upper lobe tumours and an upper zone Mediastinal Lymph Node dissection might be unnecessary for lower lobe tumours.

  • incidence and distribution of lobe specific Mediastinal Lymph Node metastasis in non small cell lung cancer data from 4511 resected cases
    Annals of Surgical Oncology, 2018
    Co-Authors: Run Bin Liang, Xin Wang, Lan Jun Zhang, Jie Yang, Tai Shan Zeng, Hao Long, Peng Lin, Tiehua Rong, Xue Hou, Haoxian Yang
    Abstract:

    We aimed to investigate the incidence and distribution of Mediastinal Lymph Node metastases (MLNM) in operable non-small cell lung cancer (NSCLC) with the purpose of guiding Mediastinal Lymph Node dissection (MLND). A total of 4511 NSCLC patients who underwent resection between January 2001 and December 2014 were included. These patients were preoperatively untreated and grouped according to the primary tumor lobes. The incidence and distribution of pathologic MLNM were compared among groups, and multivariate analysis was conducted to find the independent factors impacting MLNM. Lymph Node involvement was observed in 1784 patients (39.5%). A total of 628 cases (13.9%) were N1-positive only, 752 cases (16.7%) were both N1- and N2-positive, and 404 cases (9.0%) were N2-positive only. The most common sites of Mediastinal metastasis for different primary tumor lobes were the right upper lobe, station 4R (21.5%, 192/893); right middle lobe, station 7 (21.1%, 69/327); right lower lobe, station 7 (24.1%, 212/878); left upper lobe, station 5 (22.2%, 224/1008); and left lower lobe, station 7 (21.7%, 136/628). However, when only N2 cases were considered, each Mediastinal Lymph Node zone can be involved with metastasis to a high proportion (> 5%). Multivariable analyses showed that poor cell differentiation, adenocarcinoma, larger tumor size, central type, and younger age were independent factors favoring MLNM. Different primary tumor locations have a different propensity to be sites of MLNM; however, once MLNM occurs, each zone can be involved and should not be neglected. Systematic MLND is the preferred procedure for operable NSCLC.

  • endobronchial ultrasound guided transbronchial needle aspiration versus cervical mediastinoscopy in lung cancer diagnosis and Mediastinal staging a retrospective comparison study
    Journal of Clinical Oncology, 2017
    Co-Authors: Rong Zhang, Xin Wang, Xiaoyan Gao, Guangyu Luo, Qingguang Lin, Y Yang, Li Zhang
    Abstract:

    e20066Background: Invasive Mediastinal Lymph Node staging is essential for resectable lung cancers. This retrospective study compares the diagnosis yield of endobronchial ultrasound-guided transbro...

  • evaluation of scalene Lymph Node or contralateral mediastinum biopsy during mediastinoscopy for non small cell lung cancer
    Chinese journal of oncology, 2009
    Co-Authors: Shi Yi Zhang, Xin Wang, Ze Ming Xie, Jun Ye Wang, Xuan Xie, Jia Liang Zhou, Lan Jun Zhang
    Abstract:

    Objective To explore the clinical indication of N3 Lymph Node biopsy during mediastinoscopy for non-small cell lung cancer （NSCLC）. Methods Cervical mediastinoseopy was performed in 89 patients with clinical stage Ⅰ -Ⅲ A non-small cell lung cancer prior to thoracotomy. Of those, 12 underwent cervical medistinoscopy combined with right scalene Lymph Node biopsy and 10 with anterior mediastinotomy. Resnlts Nine patients were found to have Lymph Node metastasis （ N3 disease ） during mediastinosopy. Of those, 6 had contralateral Mediastinal Lymph Node metastasis and 3 cases with right scalene Lymph Node metastasis. The incidence of N3 disease in the patients with adenocarcinoma, serum CEA 〉 5 ng/ml and multi-station Mediastinal Lymph Node metastasis was significantly higher than that in those with non-adenocarcinoma, CEA 〈 5 ng/ml and ipsilateral uni-station Mediastinal Lymph Nodes metastasis （ P 〈 0.05 ）. Conclusion Biopsy of scalene Lymph Node or contralateral Mediastinal Lymph Node should be performed during mediastinoscopy in order to exclude N3 disease for potentially operable NSCLC patients with adenocarcinoma, serum CEA 〉 5 ng/ml and ipsilateral multi-station Mediastinal Lymph Nodes metastasis. Key words: Lung neoplasms ;  Mediastinoscopy ;  Neoadjuvant Chemotherapy

Lisa W Le - One of the best experts on this subject based on the ideXlab platform.

  • a prospective controlled trial of endobronchial ultrasound guided transbronchial needle aspiration compared with mediastinoscopy for Mediastinal Lymph Node staging of lung cancer
    The Journal of Thoracic and Cardiovascular Surgery, 2011
    Co-Authors: Kazuhiro Yasufuku, A Pierre, Gail Darling, Marc De Perrot, Thomas K Waddell, Michael R Johnston, Gilda Da Cunha Santos, William R Geddie, Scott Boerner, Lisa W Le
    Abstract:

    Objective The study objective was to compare endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with mediastinoscopy for Mediastinal Lymph Node staging of potentially resectable non–small cell lung cancer. Methods Patients with confirmed or suspected non–small cell lung cancer who required mediastinoscopy to determine suitability for lung cancer resection were entered into the trial. All patients underwent EBUS-TBNA followed by mediastinoscopy under general anesthesia. If both were negative for N2 or N3 disease, the patient underwent pulmonary resection and Mediastinal Lymphadenectomy. Results Between July 2006 and August 2010, 190 patients were registered in the study, 159 enrolled, and 153 were eligible for analysis. EBUS-TBNA and mediastinoscopy sampled an average of 3 and 4 Lymph Node stations per patient, respectively. The mean short axis of the Lymph Node biopsied by EBUS-TBNA was 6.9 ± 2.9 mm. The prevalence of N2/N3 disease was 35% (53/153). There was excellent agreement between EBUS-TBNA and mediastinoscopy for Mediastinal staging in 136 patients (91%; Kappa, 0.8; 95% confidence interval, 0.7–0.9). Specificity and positive predictive value for both techniques were 100%. The sensitivity, negative predictive value, and diagnostic accuracy for Mediastinal Lymph Node staging for EBUS-TBNA and mediastinoscopy were 81%, 91%, 93%, and 79%, 90%, 93%, respectively. No significant differences were found between EBUS-TBNA and mediastinoscopy in determining the true pathologic N stage (McNemar's test, P  = .78). There were no complications from EBUS-TBNA. Minor complications from mediastinoscopy were observed in 4 patients (2.6%). Conclusions EBUS-TBNA and mediastinoscopy achieve similar results for the Mediastinal staging of lung cancer. As performed in this study, EBUS-TBNA can replace mediastinoscopy in patients with potentially resectable non–small cell lung cancer.