MEDIASTINAL STAGING surgical pro
|
|
- Lee Hunter
- 5 years ago
- Views:
Transcription
1 MEDIASTINAL STAGING surgical pro Paul E. Van Schil, MD, PhD Department of Thoracic and Vascular Surgery University of Antwerp, Belgium Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion
2 Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion N factor: zones Rusch V. J Thorac Oncol 2009; 4:568-77
3 TNM 7th edition Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion
4 Cervical mediastinoscopy Cervical mediastinoscopy % abnormal lymph nodes exploratory thoracotomy : % bilateral exploration (N3 disease) mediastinal invasion primary tumor staging NSCLC: not indicated when both CT and PET are negative: LN < 1 cm and no FDG uptake unless central tumor or FDG uptake in primary tumor
5
6
7 Cervical mediastinoscopy hot spots low cervical, supraclavicular + sternal notch nodes(1) upper paratracheal (2 R-L) lower paratracheal (4R-L) ant. subcarinal (7A) blind spots aortopulmonary (5,6) post. subcarinal (7P) esophageal (8) inf. pulmonary ligament (9) scalene lymph nodes [N3] Cervical mediastinoscopy REVIEW CASES mortality < 0.5 % morbidity 2.5 % hemorrhage L recurrent nerve paralysis pneumothorax rare : tear tracheobronchial wall perforation of esophagus stroke, chylous leak, air embolus experience! Kirschner P. Chest Surg Clin North Am 1996; 6 : 1-20
8 Cervical mediastinoscopy video-assisted advantages: magnification ergonomic position of operator teaching possibility disadvantages : 2 - dimensional view cost
9 Cervical mediastinoscopy video-assisted 240 consecutive cases CT enlarged LN (short axis > 1 cm) 2 complications : pneumothorax, injury innominate artery 47 pts thoracotomy 3 FN (N2 found at operation) p staging = MS staging 44 pts (93.6 %) NSCLC sensitivity 97.3 % specificity 100 % accuracy 98.6 % safe and effective in nodal asessment of mediastinum Venissac N. Ann Thorac Surg 2003; 76: Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion
10 Anterior mediastinoscopy McNeill TM, Chamberlain JM. Ann Thorac Surg 1966; 2: 532 Anterior mediastinoscopy disadvantages limited exposure cosmetic appearance morbidity (pain, infection) alternatives extended cervical mediastinoscopy VATS
11 Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion Extended mediastinoscopy Aortopulmonary window indications LN 5,6 invasion aortopulmonary window technique from cervical incision prevascular substernal plane innominate triangle Ginsberg R. J Thorac Cardiovasc Surg 1987; 94:
12 Extended mediastinoscopy Extended mediastinoscopy
13 Extended mediastinoscopy Aortopulmonary window results 100 tumors LUL : 20 % anterior or superior mediastinal involvement complications (> 500 cases) wound infection laceration innominate artery transient R hemiplegia Ginsberg R. Chest Surg Clin North Am 1996; 6: Extended mediastinoscopy Scalene lymph node biopsy from cervical incision rotating mediastinoscope to supraclavicular fossa 39 pts N2 at mediastinoscopy indication 6 (15 %) occult supraclavicular disease N2 before considering combined modality approach Lee J, Ginsberg R. Ann Thorac Surg 1996; 62:
14 Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion VATS : Staging video-assisted technique adjunct to cervical mediastinoscopy replaces ant. or extended MS accessible lymph nodes : aortopulmonary (5,6) inferior mediastinal (7 post., 8, 9) hilar (10)
15 VATS : Staging indications for thoracoscopy lymph node staging pleural dissemination pleural effusion intrapulmonary metastasis before start of neoadjuvant therapy VATS Staging N2 disease 53-year-old 1994 breast cancer conservative resection + adjuvant chemoradiotherapy 1999 cervix cancer vaginal hysterectomy Sjögren s disease (ocular manifestations) follow-up chest CT: nodule L lung hilar and mediastinal LN
16 VATS : Staging
17 Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion Alternative (less) invasive tests 1ary staging sensitivity PPV FN transbronchial needle aspiration (TBNA) 76 % 100 % 29 % endoscopic ultrasound (EUS-NA) 88 % 98 % 23 % transthoracic needle aspiration (TTNA) 91 % 100 % 22 % selected population, high prevalence confirmation mediastinal involvement but FN rate alternative techniques to obtain proof N2,N3,T4 induction therapy mediastinoscopy Urschel J. Lung Cancer 2003; vol 41 suppl 3: S105 Detterbeck FC. Chest 2003; 123 (suppl 1): S167-S175
18 Accuracy PET - CT scanning anno patients operated lung cancer PET-CT followed by staging mediastinoscopy and resection, if appropriate PET-CT correct staging 99 pts 49.5 % under-staged % over-staged % superior mediastinal nodes not correctly staged in 19 % Carnochan FM, Walker WS. Eur J Cardiothorac Surg 2009; 35:781 True FN rate EUS and EBUS anno patients with lung cancer over 1.5 years FN rate EBUS 29.4 % EUS 14.3 % mediastinoscopy 5.8 % EBUS and EUS useful initial tests EBUS FN rate 4R, 7: mediastinoscopy EUS FN rate 5, 6: VATS Cerfolio RJ. Society of Thoracic Surgeons (STS) congress, 26/01/10
19 Invasive staging guidelines Recommendations 1 strong 2 weak evidence A high B moderate C (very) low Detterbeck FC. Chest 2007; 132: Invasive staging guidelines extensive mediastinal infiltration of tumor (no distant mets) CT assessment sufficient recommend. 2C enlarged, discrete mediastinal nodes by CT (no distant mets): invasive staging (regardless of PET findings) recommend. 1B confirmation N2,3: TBNA, TTNA, EUS-NA EBUS-NA (experience!) recommend. 1B needle technique - mediastinoscopy recommend. 1C Detterbeck FC. Chest 2007; 132:
20 Invasive staging guidelines normal mediastinum on chest CT in case of central tumor or N1 and no distant mets invasive staging (regardless of PET findings) mediastinoscopy suggested (alternative EUS- or EBUS-NA) recommend. 1C recommend. 2C peripheral stage I with + mediastinal nodes PET (no distant mets): mediastinoscopy suggested (alternative EUS- or EBUS-NA) recommend. 1C peripheral stage I with - mediastinal nodes PET (no distant mets): invasive confirmation not needed recommend. 1C Detterbeck FC. Chest 2007; 132: Invasive staging guidelines LUL cancer, invasive mediastinal staging indicated invasive staging of aortopulmonary nodes 5,6 suggested (other mediastinal lymph node stations not involved) methods: anterior mediastinoscopy extended cervical mediastinoscopy thoracoscopy VATS EUS-NA EBUS-NA recommend. 2C Detterbeck FC. Chest 2007; 132:
21 Mediastinal staging Invasive techniques lymph node mapping cervical mediastinoscopy anterior mediastinoscopy extended mediastinoscopy thoracoscopy (VATS) alternative, less invasive techniques conclusion different methods Mediastinal staging surgical pro cervical - anterior mediastinoscopy extended cervical mediastinoscopy thoracoscopy VATS no randomized studies available large samples: molecular genetic analysis complete evaluation, high accuracy safe techniques, morbidity Try it and you will like it!
22
Video-Mediastinoscopy Thoracoscopy (VATS)
Surgical techniques Video-Mediastinoscopy Thoracoscopy (VATS) Gunda Leschber Department of Thoracic Surgery ELK Berlin Chest Hospital, Berlin, Germany Teaching Hospital of Charité Universitätsmedizin Berlin
More informationMediastinoscopy. EBUS versus Mediastinoscopy?
Mediastinoscopy M.A. Paul, MD, PhD Dept of Surgery VU University Medical Center Amsterdam Perspectives in Lung Cancer, Amsterdam 9 10 March 2012 1 EBUS versus Mediastinoscopy? I had prepared for a Pro
More informationAn Update: Lung Cancer
An Update: Lung Cancer Andy Barlow Consultant in Respiratory Medicine Lead Clinician for Lung Cancer (West Herts Hospitals NHS Trust) Lead for EBUS-Harefield Hospital (RB&HFT) Summary Lung cancer epidemiology
More informationMediastinal Staging. Samer Kanaan, M.D.
Mediastinal Staging Samer Kanaan, M.D. Overview Importance of accurate nodal staging Accuracy of radiographic staging Mediastinoscopy EUS EBUS Staging TNM Definitions T Stage Size of the Primary Tumor
More informationThe Itracacies of Staging Patients with Suspected Lung Cancer
The Itracacies of Staging Patients with Suspected Lung Cancer Gerard A. Silvestri, MD,MS, FCCP Professor of Medicine Medical University of South Carolina Charleston, SC silvestri@musc.edu Staging Lung
More informationDiagnostic Value of EBUS-TBNA in Various Lung Diseases (Lymphoma, Tuberculosis, Sarcoidosis)
Diagnostic Value of EBUS-TBNA in Various Lung Diseases (Lymphoma, Tuberculosis, Sarcoidosis) Sevda Sener Cömert, MD, FCCP. SBU, Kartal Dr.Lütfi Kırdar Training and Research Hospital Department of Pulmonary
More informationPatients with pathologically diagnosed involved mediastinal
MINI-SYMPOSIUM ON EMERGING TECHNIQUES FOR LUNG CANCER STAGING European Trends in Preoperative and Intraoperative Nodal Staging: ESTS Guidelines P. De Leyn, MF, PhD,* D. Lardinois, MD, P. Van Schil, MD,
More informationLes techniques invasives et minimalement invasives dans le staging du cancer bronchopulmonaire. V. Ninane, Hôpital Saint-Pierre, Bruxelles, Belgique
Les techniques invasives et minimalement invasives dans le staging du cancer bronchopulmonaire V. Ninane, Hôpital Saint-Pierre, Bruxelles, Belgique 1 Invasive Mediastinal Staging Purpose : to exclude Involvement
More informationInvasive Mediastinal Staging of Lung Cancer* ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)
Supplement DIAGNOSIS AND MANAGEMENT OF LUNG CANCER: ACCP GUIDELINES Invasive Mediastinal Staging of Lung Cancer* ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Frank C. Detterbeck, MD,
More informationThe Various Methods to Biopsy the Lung PROF SHITRIT DAVID HEAD, PULMONARY DEPARTMENT MEIR MEDICAL CENTER, ISRAEL
The Various Methods to Biopsy the Lung PROF SHITRIT DAVID HEAD, PULMONARY DEPARTMENT MEIR MEDICAL CENTER, ISRAEL Conflict of Interest This presentation is supported by AstraZeneca Two main steps before
More informationRole of EBUS in mediastinal staging of lung cancer. -Dr. Nandakishore Baikunje
Role of EBUS in mediastinal staging of lung cancer -Dr. Nandakishore Baikunje Overview of the seminar Introduction Endosonography to stage the mediastinum Technical aspects of EBUS-TBNA for mediastinal
More informationEndobronchial Ultrasound in the Diagnosis & Staging of Lung Cancer
Endobronchial Ultrasound in the Diagnosis & Staging of Lung Cancer Dr Richard Booton PhD FRCP Lead Lung Cancer Clinician, Consultant Respiratory Physician & Speciality Director Manchester University NHS
More informationThe currently used standard cervical mediastinoscopy (SCM)
ORIGINAL ARTICLE The Role of Extended Cervical Mediastinoscopy in Staging of Non-small Cell Lung Cancer of the Left Lung and a Comparison with Integrated Positron Emission Tomography and Computed Tomography
More informationEndoscopic and Endobronchial Ultrasound Staging for Lung Cancer. Michael B. Wallace, MD, MPH Professor of Medicine Mayo Clinic, Jacksonville
Endoscopic and Endobronchial Ultrasound Staging for Lung Cancer Michael B. Wallace, MD, MPH Professor of Medicine Mayo Clinic, Jacksonville Background: Lung Cancer 170,000 cases/yr in U.S. (# 1 cancer)
More informationPneumonectomy After Induction Rx: Is it Safe?
Pneumonectomy After Induction Rx: Is it Safe? David J. Sugarbaker, M.D. Director, Chief, Division of Thoracic Surgery The Olga Keith Weiss Chair of Surgery of Medicine at, Pneumonectomy after induction
More informationSurgical management of lung cancer
Surgical management of lung cancer Nick Roubos FRACS Cardiothoracic Surgeon Box Hill Hospital, Epworth Eastern Thoracic Oncology Non Small Cell Lung Cancer (NSCLC) Small Cell Lung Cancer Mesothelioma Pulmonary
More informationAdam J. Hansen, MD UHC Thoracic Surgery
Adam J. Hansen, MD UHC Thoracic Surgery Sometimes seen on Chest X-ray (CXR) Common incidental findings on computed tomography (CT) chest and abdomen done for other reasons Most lung cancers discovered
More informationCharles Mulligan, MD, FACS, FCCP 26 March 2015
Charles Mulligan, MD, FACS, FCCP 26 March 2015 Review lung cancer statistics Review the risk factors Discuss presentation and staging Discuss treatment options and outcomes Discuss the status of screening
More informationPET/CT in lung cancer
PET/CT in lung cancer Andrei Šamarin North Estonia Medical Centre 3 rd Baltic Congress of Radiology 08.10.2010 Imaging in lung cancer Why do we need PET/CT? CT is routine imaging modality for staging of
More informationPET CT for Staging Lung Cancer
PET CT for Staging Lung Cancer Rohit Kochhar Consultant Radiologist Disclosures Neither I nor my immediate family members have financial relationships with commercial organizations that may have a direct
More informationVIDEO-ASSISTED MEDIASTINOSCOPY FOR MEDIASTINAL STAGING OF LUNG CANCER
VIDEO-ASSISTED MEDIASTINOSCOPY FOR MEDIASTINAL STAGING OF LUNG CANCER Christophoros N. Foroulis Associate Professor of Thoracic Surgery Aristotle University of Thessaloniki 1 st International Course on
More informationStandardized transbronchial needle aspiration procedure for intrathoracic lymph node staging of non-small cell lung cancer
Original Article on Transbronchial Needle Aspiration (TBNA) Standardized transbronchial needle aspiration procedure for intrathoracic lymph node staging of non-small cell lung cancer Xu-Ru Jin 1 *, Min
More informationImproving the Inaccuracies of Clinical Staging of Patients with NSCLC: A Prospective Trial
Improving the Inaccuracies of Clinical Staging of Patients with NSCLC: A Prospective Trial Robert James Cerfolio, MD, FACS, Ayesha S. Bryant, MD, MSPH, Buddhiwardhan Ojha, MD, MPH, and Mohammad Eloubeidi,
More informationINTERACTIVE SESSION 2
INTERACTIVE SESSION 2 2 patients with lung metastases, with complete response after oncologic treatment - Clinical Case Presentation: Dr. Esther Casado Dr. Sergi Call - Expert Opinion: Dr. Raúl Embún Dr.
More informationGROUP 1: Peripheral tumour with normal hilar and mediastinum on staging CT with no disant metastases. Including: Excluding:
GROUP 1: Including: Excluding: Peripheral tumour with normal hilar and mediastinum on staging CT with no disant metastases Solid pulmonary nodules 8mm diameter / 300mm3 volume and BROCK risk of malignancy
More informationLung Cancer. Current Therapy JEREMIAH MARTIN MBBCh FRCSI MSCRD
Lung Cancer Current Therapy JEREMIAH MARTIN MBBCh FRCSI MSCRD Objectives Describe risk factors, early detection & work-up of lung cancer. Define the role of modern treatment options, minimally invasive
More informationVAMLA/TEMLA. Todd L. Demmy
VAMLA/TEMLA Todd L. Demmy Disclosures/ Questions Objectives - Staging Learn new lymphadenectomy (LA) results: Video-Assisted Mediastinal (VAMLA) Transcervical Extended Mediastinal (TEMLA) Compare with
More informationTristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease
Tristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease Jennifer E. Tseng, MD UFHealth Cancer Center-Orlando Health Sep 12, 2014 Background Approximately
More informationFDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave
FDG PET/CT STAGING OF LUNG CANCER Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER FDG PET/CT is used in all patients with lung cancer who are considered for curative treatment to exclude occult disease.
More informationCase presentation. Paul De Leyn, MD, PhD Thoracic Surgery University Hospitals Leuven Belgium
Case presentation Paul De Leyn, MD, PhD Thoracic Surgery University Hospitals Leuven Belgium Perspectives in Lung Cancer Brussels 6-7 march 2009 LEUVEN LUNG CANCER GROUP Department of Thoracic Surgery
More informationEndoscopic ultrasound-guided needle aspiration in lung cancer
ORIGINAL ARTICLE Artur Szlubowski 1, Marcin Zieliński 1, Joanna Figura 1, Jolanta Hauer 1, Witold Sośnicki 1, Juliusz Pankowski 2, Anna Obrochta 2, Magdalena Jakubiak 2 1 Department of Thoracic Surgery
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer
THIS DOCUMENT IS North of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer [Based on WOSCAN NSCLC CMG with further extensive consultation within NOSCAN] UNCONTROLLED
More informationLung cancer Surgery. 17 TH ESO-ESMO MASTERCLASS IN CLINICAL ONCOLOGY March, 2017 Berlin, Germany
17 TH ESO-ESMO MASTERCLASS IN CLINICAL ONCOLOGY 24-29 March, 2017 Berlin, Germany Lung cancer Surgery Sven Hillinger MD, Thoracic Surgery, University Hospital Zurich Case 1 59 y, female, 40 py, incidental
More informationMediastinoscopy, Mediastinotomy And Thoracoscopy For Mediastinal Lesions. Alper Toker, MD
Mediastinoscopy, Mediastinotomy And Thoracoscopy For Mediastinal Lesions Alper Toker, MD Istanbul University, Istanbul Medical School Department of Thoracic Surgery The mediastinum is a complex anatomic
More informationLung Cancer staging Role of ENDOBRONCHIAL ULTRASOUND(Ebus) EBUS
Lung Cancer staging Role of ENDOBRONCHIAL ULTRASOUND(Ebus) Arvind Perathur Winter Retreat Feb 13 th 2011 Mason City IA 50401 EBUS Tiger now offers a very economical and environmentally friendly all electric
More informationLung Cancer Update. Disclosures. None
Lung Cancer Update Ronald J Servi DO FCCP Adjunct Assistant Professor Department of Pulmonary Medicine University of Texas MD Anderson Cancer Center Banner MD Anderson Cancer Center Gilbert, Arizona Disclosures
More informationVideo assisted mediastinal lymphadenectomy (VAMLA)
Video assisted mediastinal lymphadenectomy (VAMLA) Gunda Leschber Department of Thoracic Surgery ELK Berlin Chest Hospital, Berlin, Germany Teaching Hospital of Charité Universitätsmedizin Berlin No conflict
More informationThe right middle lobe is the smallest lobe in the lung, and
ORIGINAL ARTICLE The Impact of Superior Mediastinal Lymph Node Metastases on Prognosis in Non-small Cell Lung Cancer Located in the Right Middle Lobe Yukinori Sakao, MD, PhD,* Sakae Okumura, MD,* Mun Mingyon,
More informationSlide 1. Slide 2. Slide 3. Investigation and management of lung cancer Robert Rintoul. Epidemiology. Risk factors/aetiology
Slide 1 Investigation and management of lung cancer Robert Rintoul Department of Thoracic Oncology Papworth Hospital Slide 2 Epidemiology Second most common cancer in the UK (after breast). 38 000 new
More informationUtility of PET-CT for detection of N2 or N3 nodal mestastases in the mediastinum in patients with non-small cell lung cancer (NSCLC)
Utility of PET-CT for detection of N2 or N3 nodal mestastases in the mediastinum in patients with non-small cell lung cancer (NSCLC) Poster No.: C-1360 Congress: ECR 2015 Type: Scientific Exhibit Authors:
More informationGUIDELINE RECOMMENDATIONS
European Journal of Cardio-Thoracic Surgery 48 (2015) 1 15 doi:10.1093/ejcts/ezv194 Cite this article as: Vilmann P, Frost Clementsen P, Colella S, Siemsen M, De Leyn P, Dumonceau J-M et al. Combined endobronchial
More informationGUIDELINES FOR CANCER IMAGING Lung Cancer
GUIDELINES FOR CANCER IMAGING Lung Cancer Greater Manchester and Cheshire Cancer Network Cancer Imaging Cross-Cutting Group April 2010 1 INTRODUCTION This document is intended as a ready reference for
More informationRecommendations 1 For mediastinal nodal staging in patients with suspected or proven non-small-cell lung cancer
Guideline 545 Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the
More informationAccepted Manuscript. Indications for Invasive Mediastinal Staging for Non-small Cell Lung Cancer. Jules Lin, MD, Felix Fernandez, MD
Accepted Manuscript Indications for Invasive Mediastinal Staging for Non-small Cell Lung Cancer Jules Lin, MD, Felix Fernandez, MD PII: S0022-5223(18)31872-5 DOI: 10.1016/j.jtcvs.2018.07.027 Reference:
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationMediastinal Mysteries: What can be solved with EBUS?
Mediastinal Mysteries: What can be solved with EBUS? W. Graham Carlos MD Pulmonary & Critical Care Fellow Indiana University School of Medicine Disclosures None Objectives Introduce you to the technique
More informationEBUS-TBNA in PET-positive lymphadenopathies in treated cancer patients
ORIGINAL ARTICLE LUNG IMAGING EBUS-TBNA in PET-positive lymphadenopathies in treated cancer patients Juliana Guarize 1, Monica Casiraghi 1, Stefano Donghi 1, Chiara Casadio 2, Cristina Diotti 1, Niccolò
More informationEducational Objectives. Managing Lung Cancer From the Solitary Pulmonary Nodule to Complex Cases: A Multidisciplinary Approach.
Managing Lung Cancer From the Solitary Pulmonary Nodule to Complex Cases: A Multidisciplinary Approach Robert A. Meguid, MD, MPH, FACS Assistant Professor of Cardiothoracic Surgery Surgical Director, Surgical
More informationUNDERSTANDING SERIES LUNG CANCER BIOPSIES LungCancerAlliance.org
UNDERSTANDING SERIES LUNG CANCER BIOPSIES 1-800-298-2436 LungCancerAlliance.org CONTENTS What is a Biopsy?...2 Non-Surgical Biopsies...3 Surgical Biopsies...5 Biopsy Risks...6 Biopsy Results...6 Questions
More informationCase Scenario 1. The patient agreed to a CT guided biopsy of the left upper lobe mass. This was performed and confirmed non-small cell carcinoma.
Case Scenario 1 An 89 year old male patient presented with a progressive cough for approximately six weeks for which he received approximately three rounds of antibiotic therapy without response. A chest
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More informationRevised ESTS guidelines for preoperative mediastinal lymph node staging for non-small cell lung cancer
Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small cell lung cancer Paul De Leyn 1, Christophe Dooms 2, Jaroslaw Kuzdzal 3, Didier Lardinois 4, Bernward Passlick 5, Ramon
More informationRespiratory Interactive Session. Elaine Borg
Respiratory Interactive Session Elaine Borg Case 1 Respiratory Cytology 55 year old gentleman Anterior mediastinal mass EBUS FNA Case 1 Respiratory Cytology 55 year old gentleman with anterior mediastinal
More informationCollaborative Stage. Site-Specific Instructions - LUNG
Slide 1 Collaborative Stage Site-Specific Instructions - LUNG In this presentation, we are going to review the AJCC Cancer Staging criteria for the lung primary site. Slide 2 Reading Assignments As each
More informationVideo-assisted thoracoscopic surgery in lung cancer staging
Review Article on Thoracic Surgery Page 1 of 7 Video-assisted thoracoscopic surgery in lung cancer staging Frederico Krieger Martins, Guilherme Augusto Oliveira, Juliano Cé Coelho, Márcio Chmelnitsky Kruter,
More informationLarry Tan, MD Thoracic Surgery, HSC. Community Cancer Care Educational Conference October 27, 2017
Larry Tan, MD Thoracic Surgery, HSC Community Cancer Care Educational Conference October 27, 2017 To describe patient referral & triage for the patient with suspected lung cancer To describe the initial
More informationMinimally Invasive Mediastinal Staging of Non Small-Cell Lung Cancer: Emphasis on Ultrasonography-Guided Fine-Needle Aspiration
Endobronchial ultrasound and endoscopic ultrasound-guided lymph node biopsy may represent an alternative to cervical mediastinoscopy. Dorothy Fox, Rough Seas. Acrylic on canvas, 36ʺ 36ʺ. Minimally Invasive
More informationT3 NSCLC: Chest Wall, Diaphragm, Mediastinum
for T3 NSCLC: Chest Wall, Diaphragm, Mediastinum AATS Postgraduate Course April 29, 2012 Thomas A. D Amico MD Professor of Surgery, Chief of Thoracic Surgery Duke University Health System Disclosure No
More informationS taging non-small lung cancer (NSCLC) is an important
696 LUNG CANCER Integrated FDG-PET/CT does not make invasive staging of the intrathoracic lymph nodes in non-small cell lung cancer redundant: a prospective study K G Tournoy, S Maddens, R Gosselin, G
More informationEsophageal Cancer Staging Essentials: The New TNM Staging System (7th edition) and Clinicoradiologic Implications
Esophageal Cancer Staging Essentials: The New TNM Staging System (7th edition) and Clinicoradiologic Implications Poster No.: E-0060 Congress: ESTI 2012 Type: Scientific Exhibit Authors: K. Lee, T. J.
More informationEndoscopic Ultrasound-Guided Fine- Needle Aspiration for Non-small Cell Lung Cancer Staging* A Systematic Review and Metaanalysis
CHEST Endoscopic Ultrasound-Guided Fine- Needle Aspiration for Non-small Cell Lung Cancer Staging* A Systematic Review and Metaanalysis Carlos G. Micames, MD; Douglas C. McCrory, MD; Darren A. Pavey, MD;
More informationAJCC-NCRA Education Needs Assessment Results
AJCC-NCRA Education Needs Assessment Results Donna M. Gress, RHIT, CTR Survey Tool 1 Survey Development, Delivery, Analysis THANKS to NCRA for the following work Developed survey with input from partners
More informationEVIDENCE BASED MANAGEMENT OF STAGE III NSCLC MILIND BALDI
EVIDENCE BASED MANAGEMENT OF STAGE III NSCLC MILIND BALDI Overview Introduction Diagnostic work up Treatment Group 1 Group 2 Group 3 Stage III lung cancer Historically was defined as locoregionally advanced
More informationPredictive risk factors for lymph node metastasis in patients with resected nonsmall cell lung cancer: a case control study
Moulla et al. Journal of Cardiothoracic Surgery (2019) 14:11 https://doi.org/10.1186/s13019-019-0831-0 RESEARCH ARTICLE Open Access Predictive risk factors for lymph node metastasis in patients with resected
More informationSeventh Edition of the Cancer Staging Manual and Stage Grouping of Lung Cancer. Quick Reference Chart and Diagrams
CHEST Special Features Seventh Edition of the Cancer Staging Manual and Stage Grouping of Lung Cancer Quick Reference Chart and Diagrams Omar Lababede, MD ; Moulay Meziane, MD ; and Thomas Rice, MD, FCCP
More informationRole of Surgery in Management of Non Small Cell Lung Cancer. Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City
Role of Surgery in Management of Non Small Cell Lung Cancer Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City Introduction Surgical approach Principle and type of surgery
More informationLung Cancer: Determining Resectability
Lung Cancer: Determining Resectability Leslie E. Quint lequint@umich.edu No disclosures Lung Cancer: Determining Resectability AIM: Review imaging features that suggest resectability / unresectability
More informationAccurate mediastinal staging is a critical component
Endobronchial Ultrasound for Lung Cancer Staging: How Many Stations Should Be Sampled? Mark I. Block, MD Thoracic Surgery, Memorial Healthcare System, Hollywood, Florida Background. No guidelines exist
More informationFDG PET/CT in Lung Cancer Read with the experts. Homer A. Macapinlac, M.D.
FDG PET/CT in Lung Cancer Read with the experts Homer A. Macapinlac, M.D. Patient with suspected lung cancer presents with left sided chest pain T3 What is the T stage of this patient? A) T2a B) T2b C)
More informationSatellite Pulmonary Nodule in the Same Lobe (T4N0) Should Not Be Staged as IIIB Non Small Cell Lung Cancer
Satellite Pulmonary Nodule in the Same Lobe (T4N0) Should Not Be Staged as IIIB Non Small Cell Lung Cancer Ayesha S. Bryant, MSPH, MD, Sara J. Pereira, MD, Daniel L. Miller, MD, and Robert James Cerfolio,
More informationEndoscopic UltraSound (EUS) Endoscopic Mucosal Resection (EMR) Moishe Liberman Director C.E.T.O.C.
Endoscopic UltraSound (EUS) Endoscopic Mucosal Resection (EMR) Moishe Liberman Director C.E.T.O.C. Division of Thoracic Surgery Centre Hospitalier de l Université de Montréal Research Grants: Disclosures
More informationDIAGNOSIS OF LUNG CANCER. Dr. Sayeed ahmed, Assistant prof, MD,DAA.
DIAGNOSIS OF LUNG CANCER Dr. Sayeed ahmed, Assistant prof, MD,DAA. Diagnosis of lung cancer can be done by 1) Clinical presentation 2) Investigations a) non invasive b) invasive Clinical Presentation Metastatic
More informationControversies in management of squamous esophageal cancer
2015.06.12 12.47.48 Page 4(1) IS-1 Controversies in management of squamous esophageal cancer C S Pramesh Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, India In Asia, squamous
More informationMEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER
MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER Tsuneyo Takizawa, MD a Masanori Terashima, MD a Teruaki Koike, MD a Hideki Akamatsu, MD a Yuzo
More informationThe Role of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis of Recurrent Non-small Cell Lung Cancer after Surgery
ORIGINAL ARTICLE The Role of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis of Recurrent Non-small Cell Lung Cancer after Surgery Seo Goo Han 1, Hongseok Yoo 1, Byung
More informationUtility of endobronchial ultrasound guided mediastinal lymph node biopsy in patients with non small cell lung cancer
GENERAL THORACIC SURGERY Utility of endobronchial ultrasound guided mediastinal lymph node biopsy in patients with non small cell lung cancer Benjamin E. Lee, MD, a,b Elaine Kletsman, PA, a,b John R. Rutledge,
More informationIn 1982 Pearson and colleagues [1] from Toronto published
Transition From Mediastinoscopy to Endoscopic Ultrasound for Lung Cancer Staging Mark I. Block, MD Division of Thoracic Surgery, Memorial Healthcare System, Hollywood, Florida Background. Esophageal endoscopic
More informationPrevalence and Pattern of Lymph Node Metastasis in Malignant Pleural Mesothelioma
Prevalence and Pattern of Lymph Node Metastasis in Malignant Pleural Mesothelioma Abdel Rahman M. Abdel Rahman, MD, Rabab M. Gaafar, MD, Hoda A. Baki, MD, Hesham M. El Hosieny, MD, Fatma Aboulkasem, MD,
More informationThoracic Surgery; An Overview
Thoracic Surgery What we see Thoracic Surgery; An Overview James P. Locher, Jr, MD Methodist Cardiovascular and Thoracic Surgery Lung cancer Mets Fungus and TB Lung abcess and empyema Pleural based disease
More informationHISTORY SURGERY FOR TUMORS WITH INVASION OF THE APEX 15/11/2018
30 EACTS Annual Meeting Barcelona, Spain 1-5 October 2016 SURGERY FOR TUMORS WITH INVASION OF THE APEX lung cancer of the apex of the chest involving any structure of the apical chest wall irrespective
More informationThree-arm robot-assisted thoracoscopic surgery for locally advanced N2 non-small cell lung cancer
Surgical Technique Three-arm robot-assisted thoracoscopic surgery for locally advanced N2 non-small cell lung cancer Xinghua Cheng, Chongwu Li, Jia Huang, Peiji Lu, Qingquan Luo Shanghai Chest Hospital,
More informationComplex Thoracoscopic Resections for Locally Advanced Lung Cancer
Complex Thoracoscopic Resections for Locally Advanced Lung Cancer Duke Thoracoscopic Lobectomy Workshop March 21, 2018 Thomas A. D Amico MD Gary Hock Professor of Surgery Section Chief, Thoracic Surgery,
More informationVATS after induction therapy: Effective and Beneficial Tips on Strategy
VATS after induction therapy: Effective and Beneficial Tips on Strategy AATS Focus on Thoracic Surgery Mastering Surgical Innovation Las Vegas Nevada Oct. 27-28 2017 Scott J. Swanson, M.D. Professor of
More informationRadiological staging of lung cancer. Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh
Radiological staging of lung cancer Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh Bronchogenic Carcinoma Accounts for 14% of new cancer diagnoses in 2012. Estimated to kill ~150,000
More informationACRIN NLST 6654 Primary Lung Cancer. F1/F2 Interval: to (mm-dd-yyyy) 1. Date of diagnosis: (mm-dd-yyyy)
No. F1/F2 Interval: - - 20 to - - 20 (mm-dd-yyyy) 1. Date of diagnosis: - - 20 (mm-dd-yyyy) 2. Samples recorded: ZP Number S-Number 1) 2) 3) 4) (Refer to Form PX, Column 1. In the rare instance of a diagnosis
More informationCombined endobronchial and oesophageal endosonography for the diagnosis and staging of lung cancer
TASK FORCE REPORT ESGE/ERS/ESTS GUIDELINES Combined endobronchial and oesophageal endosonography for the diagnosis and staging of lung cancer European Society of Gastrointestinal Endoscopy (ESGE) Guideline,
More informationChirurgie beim oligo-metastatischen NSCLC
24. Ärzte-Fortbildungskurs in Klinischer Onkologie 20.-22. Februar 2014, Kantonsspital St. Gallen Chirurgie beim oligo-metastatischen NSCLC Prof. Dr. med. Walter Weder Klinikdirektor Thoraxchirurgie, UniversitätsSpital
More informationThe surgeon: new surgical aproaches
The surgeon: new surgical aproaches Paul Van Schil, MD Department of Thoracic and Vascular Surgery Antwerp University, Belgium no disclosures, no conflict of interest Malignant pleural mesothelioma: clinical,
More informationBronchoscopy and endobronchial ultrasound for diagnosis and staging of lung cancer
FRANCISCO AÉCIO ALMEIDA, MD, MS, FCCP Associate Staff Member, Director, Interventional Pulmonary Medicine Fellowship Program, Respiratory Institute, Cleveland Clinic, Cleveland, OH Bronchoscopy and endobronchial
More informationEsophageal cancer (EC) is the eighth most common cancer worldwide and the sixth most common cause of cancer-related mortality (Kamangar et al.
Arch. Biol. Sci., Belgrade, 65 (3), 821-827, 2013 DOI:10.2298/ABS1303821L DETERMINING THE LYMPH NODE CLINICAL TARGET VOLUME OF UPPER ESOPHAGEAL CARCINOMA WITH COMPUTED TOMOGRAPHY MINGHUAN LI 1, YUHUI LIU
More informationMediastinoscopy is a common procedure used for the GENERAL THORACIC SURGERY THE CURRENT ROLE OF MEDIASTINOSCOPY IN THE EVALUATION OF THORACIC DISEASE
GENERAL THORACIC SURGERY THE CURRENT ROLE OF MEDIASTINOSCOPY IN THE EVALUATION OF THORACIC DISEASE Zane T. Hammoud, MD Richard C. Anderson, MD Bryan F. Meyers, MD Tracey J. Guthrie, RN, BSN Charles L.
More informationDM SEMINAR MARCH 11, 2005
DM SEMINAR MARCH 11, 2005 STAGING PROCEDURES FOR LUNG CANCER NAVNEET SINGH DEPARTMENT OF PULMONARY MEDICINE SCOPE INTRODUCTION NON-INVASIVE PROCEDURES INVASIVE PROCEDURES PRIORITIZATION OF PROCEDURES PROBLEM
More informationLung Cancer Imaging. Terence Z. Wong, MD,PhD. Department of Radiology Duke University Medical Center Durham, NC 9/9/09
Lung Cancer Imaging Terence Z. Wong, MD,PhD Department of Radiology Duke University Medical Center Durham, NC 9/9/09 Acknowledgements Edward F. Patz, Jr., MD Jenny Hoang, MD Ellen L. Jones, MD, PhD Lung
More informationSIGN 137 Management of lung cancer. A national clinical guideline February Evidence
SIGN 137 Management of lung cancer A national clinical guideline February 2014 Evidence KEY TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONS LEVELS OF EVIDENCE 1 ++ High quality meta-analyses, systematic
More informationEsophageal Cancer: A Multimodality Approach to Detection and Staging
Esophageal Cancer: A Multimodality Approach to Detection and Staging, MBA Topic: Esophageal Cancer Imaging: A multimodality approach Conference: Society of Thoracic Imaging Location: Date/Time: March 14,
More informationMethods for Staging Non-small Cell Lung Cancer
CHEST Supplement DIAGNOSIS AND MANAGEMENT OF LUNG CANCER, 3RD ED: ACCP GUIDELINES Methods for Staging Non-small Cell Lung Cancer Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest
More informationLymph node dissection for lung cancer is both an old
LOBE-SPECIFIC EXTENT OF SYSTEMATIC LYMPH NODE DISSECTION FOR NON SMALL CELL LUNG CARCINOMAS ACCORDING TO A RETROSPECTIVE STUDY OF METASTASIS AND PROGNOSIS Hisao Asamura, MD Haruhiko Nakayama, MD Haruhiko
More informationClinical Management Guideline for Small Cell Lung Cancer
Diagnosis and Staging: Key Points 1. Ensure a CT scan that is
More informationKey words: CT scan; endobronchial ultrasound; integrated PET; lung cancer; staging
CHEST Original Research INTERVENTIONAL PULMONOLOGY Application of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Following Integrated PET/CT in Mediastinal Staging of Potentially Operable
More informationNumber of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy
CHEST Original Research Number of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy Results of the Randomized, Prospective American College of Surgeons Oncology Group Z0030 Trial LUNG CANCER Gail
More information