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Additive Value of EBUS-TBNA for Staging Non-Small Cell Lung Cancer in Patients Evaluated for Stereotactic Body Radiation Therapy

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dc.contributor.authorBoster, Joshua M.
dc.contributor.authorGoertzen, S. Michael
dc.contributor.authorSainz, Paula V.
dc.contributor.authorRodríguez Vial, Macarena
dc.contributor.authorZaveri-Desai, Jhankruti K.
dc.contributor.authorLuna, Luis D.
dc.contributor.authorGrosu, Horiana B.
dc.contributor.authorWaqar, Anum
dc.contributor.authorCasal, Roberto F.
dc.contributor.authorJimenez, Carlos A.
dc.contributor.authorOst, David E.
dc.contributor.authorSabath, Bruce F.
dc.contributor.authorLin, Julie
dc.contributor.authorHernandez, Mike
dc.contributor.authorEapen, Georgie A.
dc.date.accessioned2026-08-04T21:25:25Z
dc.date.available2026-08-04T21:25:25Z
dc.date.issued2025
dc.description.abstractBackground/Objectives: Patients with non-small cell lung cancer (NSCLC) being evaluated for stereotactic body radiation therapy (SBRT) are frequently staged non-invasively with positron emission tomography/computed tomography (PET/CT). Performing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in addition to PET/CT scanning may increase clinical certainty in lymph node staging, but the magnitude of added benefit of EBUS-TBNA over non-invasive staging methods is unclear. Methods: A single-center prospective cohort study involving patients with suspected or confirmed Stage I or IIa NSCLC referred for EBUS-TBNA prior to SBRT was performed. The primary outcome was concordance between PET/CT and EBUS-TBNA for nodal metastases. Secondary endpoints included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT, and clinical outcomes based on staging results. Results: Among 115 patients, the concordance between PET/CT and EBUS-TBNA was 84.3% (95% CI: 0.76 0.90). EBUS-TBNA led to a stage shift in 15.7% of cases: 4 of 98 PET/CT N0 patients (4.1%) had nodal metastases, while 14 of 17 PET/CT N1 patients (82.4%) were downstaged to N0. PET/CT sensitivity was 42.9% (95% CI: 0.09–0.81), specificity 87% (95% CI: 0.79–0.93), PPV 17.6% (95% CI: 0.04–0.43), and NPV 95.9% (95% CI: 0.90–0.99). PET/CT-positive, EBUS-TBNA-negative patients had worse survival (HR 4.25, 95% CI: 1.24–14.53, p = 0.021) compared with double-negative patients. Conclusions: EBUS-TBNA improves staging accuracy over PET/CT in early-stage NSCLC, impacting SBRT candidacy. However, PET/CT-positive, EBUS-TBNA-negative patients had worse outcomes in comparison to double-negative patients, suggesting a need for additional therapy or surveillance in that population.
dc.description.versionVersión publicada
dc.format.extent10 p.
dc.identifier.citationBoster, J. M., Goertzen, S. M., Sainz, P. V., Vial, M. R., Zaveri-Desai, J. K., Luna, L. D., Waqar, A., Grosu, H. B., Casal, R. F., Jimenez, C. A., Ost, D. E., Sabath, B. F., Lin, J., Hernandez, M., & Eapen, G. A. (2025). Additive Value of EBUS-TBNA for Staging Non-Small Cell Lung Cancer in Patients Evaluated for Stereotactic Body Radiation Therapy. Diagnostics, 15(17), 2136. https://doi.org/10.3390/diagnostics15172136
dc.identifier.doihttps://doi.org/10.3390/diagnostics15172136
dc.identifier.urihttps://hdl.handle.net/11447/10956
dc.language.isoen
dc.subjectLung cancer
dc.subjectStereotactic body radiation therapy
dc.subjectBronchoscopic ultrasound
dc.subjectEndobronchial ultrasound
dc.subjectStaging
dc.titleAdditive Value of EBUS-TBNA for Staging Non-Small Cell Lung Cancer in Patients Evaluated for Stereotactic Body Radiation Therapy
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourceDiagnostics
dspace.entity.typePublication

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