Minimally Invasive Methods for Staging in Lung Cancer: Systematic Review and Meta-Analysis
Journal
Pulmonary Medicine
ISSN
2090-1836
2090-1844
Date Issued
2016
Author(s)
Gonzalo Labarca
Carlos Aravena
Francisco Ortega
Alex Arenas
Adnan Majid
Erik Folch
Hiren J. Mehta
Michael A. Jantz
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:p><jats:italic>Introduction</jats:italic>. Endobronchial ultrasound (EBUS) is a procedure that provides access to the mediastinal staging; however, EBUS cannot be used to stage all of the nodes in the mediastinum. In these cases, endoscopic ultrasound (EUS) is used for complete staging.<jats:italic>Objective</jats:italic>. To provide a synthesis of the evidence on the diagnostic performance of EBUS + EUS in patients undergoing mediastinal staging.<jats:italic>Methods</jats:italic>. Systematic review and meta-analysis to evaluate the diagnostic yield of EBUS + EUS compared with surgical staging. Two researchers performed the literature search, quality assessments, data extractions, and analyses. We produced a meta-analysis including sensitivity, specificity, and likelihood ratio analysis.<jats:italic>Results</jats:italic>. Twelve primary studies (1515 patients) were included; two were randomized controlled trials (RCTs) and ten were prospective trials. The pooled sensitivity for combined EBUS + EUS was 87% (CI 84–89%) and the specificity was 99% (CI 98–100%). For EBUS + EUS performed with a single bronchoscope group, the sensitivity improved to 88% (CI 83.1–91.4%) and specificity improved to 100% (CI 99-100%).<jats:italic>Conclusion</jats:italic>. EBUS + EUS is a highly accurate and safe procedure. The combined procedure should be considered in selected patients with lymphadenopathy noted at stations that are not traditionally accessible with conventional EBUS.</jats:p>
Subjects
transbronchial needle aspiration
;
peripheral pulmonary-lesions
;
mediastinal lymph-nodes
;
endobronchial ultrasound
;
endoscopic ultrasound
;
guide-sheath
;
ebus-tbna
;
eus-fna
;
biopsy
;
endosonography