What is the accuracy of mediastinal lymphadenectomy for staging NSCLC?

Updated: Dec 10, 2019
  • Author: R James Koness, MD, FACS; Chief Editor: Erik D Schraga, MD  more...
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Answer

Call et al assessed the results of VAMLA for staging NSCLC in 160 cases, 138 of which involved clinical N0-1 cancers. [15]  They found VAMLA to be highly accurate, with a sensitivity of 0.96 (95% confidence interval [CI], 0.81-99.3), a specificity of 1 (95% CI, 0.97-1), a positive predictive value of 1 (95% CI, 0.87-1), a negative predictive value of 0.99 (95% CI, 0.95-0.99), and a diagnostic accuracy of 0.99 (95% CI, 0.96-0.99). Complications developed in 5.9% of patients.

Wang et al retrospectively studied 712 consecutive cases of clinical N0-1 lung cancer (including 152 cases of pathologic N2 disease and 560 cases of pathologic N0-1 disease confirmed after surgery) to assess whether mediastinal lymphadenectomy compliant with National Comprehensive Cancer Network (NCCN) criteria (≥3 stations of N2 node dissection) improved oncologic outcomes in this group. [16] They found that such a lymphadenectomy was a significant prognostic factor for overall survival both in the cohort as a whole and the patients with pathologic N2 status; more extended N2 node dissection did not appear to improve outcome further in the latter.


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