Endobronchial ultrasound-guided transbronchial needle aspiration in the nodal staging of stereotactic ablative body radiotherapy patients

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dc.contributor.authorVial, Macarena
dc.contributor.authorKhan, Kashif A.
dc.contributor.authorO’Connell, Oisin
dc.contributor.authorPeng, S. Andrew
dc.contributor.authorGomez, Daniel R.
dc.contributor.authorChang, Joe Y.
dc.contributor.authorRice, David C.
dc.contributor.authorMehran, Reza
dc.contributor.authorJimenez, Carlos J.
dc.contributor.authorGrosu, Horiana B.
dc.contributor.authorOst, David E
dc.contributor.authorEapen, George A.
dc.date.accessioned2017-09-12T12:42:22Z
dc.date.available2017-09-12T12:42:22Z
dc.date.issued2017
dc.description.abstractBACKGROUND: Patients with non-small cell lung cancer (NSCLC) being evaluated for stereotactic ablative body radiotherapy (SABR) are typically staged noninvasively with positron emission tomography/computed tomography (PET/CT). Incorporating endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) into the staging workup of these patients has not been evaluated. Our primary objective was to compare the performance of PET/CT with EBUS-TBNA for intrathoracic nodal assessment among SABR-eligible patients. METHODS: This was a retrospective study consisting of two parts. First, we assessed the concordance for nodal metastasis of PET/CT and EBUS-TBNA. Second, we evaluated clinical outcomes among patients who underwent SABR with and without a prior EBUS-TBNA. RESULTS: We identified 246 eligible patients. Compared with PET/CT, EBUS-TBNA led to a stage shift in 48 of 246 patients (19%). Of 174 N0 patients by PET/CT, 6 (3.4%) had nodal metastasis on EBUS-TBNA. Among 72 clinical N1 patients, 36 (50%) were downstaged to N0 after EBUS-TBNA, therefore becoming eligible for SABR. Concordance between PET/CT and EBUS-TBNA for nodal metastasis was 83% (κ = 0.53). Clinical outcomes of patients who underwent SABR with or without a prior EBUS-TBNA did not differ significantly. CONCLUSIONS: Concordance of PET/CT and EBUS-TBNA for nodal disease was only moderate. Incorporating EBUS-TBNA into the staging workup was beneficial in identifying occult nodal metastasis that would otherwise be left untreated with SABR and in expanding the pool of potentially SABR-eligible patients.
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dc.identifier.citationVial MR, Khan KA, O'Connell O, Peng SA, Gomez DR, Chang JY, Rice DC, Mehran R, Jimenez CJ, Grosu HB, Ost DE, Eapen GA. Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Nodal Staging of Stereotactic Ablative Body Radiotherapy Patients. Ann Thorac Surg. 2017 May;103(5):1600-1605
dc.identifier.urihttp://hdl.handle.net/11447/1675
dc.identifier.urihttp://dx.doi.org/ 10.1016/j.athoracsur.2016.09.106
dc.language.isoen_US
dc.publisherElsevier
dc.subjectCarcinoma, Non-Small-Cell Lung
dc.subjectEndoscopic Ultrasound-Guided Fine Needle Aspiration
dc.subjectLung Neoplasms
dc.subjectLymph Nodes
dc.subjectNeoplasm Staging
dc.subjectRadiosurgery
dc.titleEndobronchial ultrasound-guided transbronchial needle aspiration in the nodal staging of stereotactic ablative body radiotherapy patients
dc.typeArtículo

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