Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial

Introduction Both combined endobronchial ultrasonography (EBUS) and transoesophageal bronchoscopic ultrasonography (EUS-B) and EBUS alone have been recommended for preoperative mediastinal staging of nonsmall cell lung cancer (NSCLC). However, no randomised study comparing these two methods has been...

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Main Authors: Masahide Oki, Hideo Saka, Yukio Seki, Yoshihito Kogure, Hideyuki Niwa, Arisa Yamada, Atsushi Torii, Chiyoe Kitagawa, Masahiko Ando
Format: Article
Language:English
Published: European Respiratory Society 2024-12-01
Series:ERJ Open Research
Online Access:http://openres.ersjournals.com/content/10/6/00326-2024.full
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author Masahide Oki
Hideo Saka
Yukio Seki
Yoshihito Kogure
Hideyuki Niwa
Arisa Yamada
Atsushi Torii
Chiyoe Kitagawa
Masahiko Ando
author_facet Masahide Oki
Hideo Saka
Yukio Seki
Yoshihito Kogure
Hideyuki Niwa
Arisa Yamada
Atsushi Torii
Chiyoe Kitagawa
Masahiko Ando
author_sort Masahide Oki
collection DOAJ
description Introduction Both combined endobronchial ultrasonography (EBUS) and transoesophageal bronchoscopic ultrasonography (EUS-B) and EBUS alone have been recommended for preoperative mediastinal staging of nonsmall cell lung cancer (NSCLC). However, no randomised study comparing these two methods has been published. The purpose of the present study was to compare the sensitivity of EBUS and that of combined EBUS and EUS-B (EBUS/EUS-B) in terms of detecting N2/N3 disease during staging of NSCLC. Methods Patients with known or suspected, potentially operable NSCLC were recruited and randomised to undergo EBUS or EBUS/EUS-B under conscious sedation. The primary end-point was a comparison of the sensitivity of EBUS alone and EBUS/EUS-B. Results A total of 240 patients were enrolled and randomised, among whom 219 (105 EBUS group; 114 EBUS/EUS-B group) were included in the analysis. The sensitivities of EBUS and EBUS/EUS-B in terms of detecting N2/N3 disease were 75.0% and 79.3% respectively (p=0.698). In the EBUS/EUS-B group, only EUS-B yielded diagnostic results in two patients; the sensitivity thus increased from 72.4% to 79.3% on addition of EUS-B to EBUS. Conclusions The difference in the sensitivities of EBUS alone and EBUS/EUS-B in terms of diagnosing N2/N3 disease was not statistically significant. Although the increase in sensitivity with the addition of EUS-B is modest, it is maximised when EUS-B is used to sample lymph nodes not accessible by EBUS alone.
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spelling doaj-art-532abca8870545188e22a940b38c55f22025-01-14T09:50:21ZengEuropean Respiratory SocietyERJ Open Research2312-05412024-12-0110610.1183/23120541.00326-202400326-2024Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trialMasahide Oki0Hideo Saka1Yukio Seki2Yoshihito Kogure3Hideyuki Niwa4Arisa Yamada5Atsushi Torii6Chiyoe Kitagawa7Masahiko Ando8 Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan Department of Thoracic Surgery, NHO Nagoya Medical Center, Nagoya, Japan Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan Introduction Both combined endobronchial ultrasonography (EBUS) and transoesophageal bronchoscopic ultrasonography (EUS-B) and EBUS alone have been recommended for preoperative mediastinal staging of nonsmall cell lung cancer (NSCLC). However, no randomised study comparing these two methods has been published. The purpose of the present study was to compare the sensitivity of EBUS and that of combined EBUS and EUS-B (EBUS/EUS-B) in terms of detecting N2/N3 disease during staging of NSCLC. Methods Patients with known or suspected, potentially operable NSCLC were recruited and randomised to undergo EBUS or EBUS/EUS-B under conscious sedation. The primary end-point was a comparison of the sensitivity of EBUS alone and EBUS/EUS-B. Results A total of 240 patients were enrolled and randomised, among whom 219 (105 EBUS group; 114 EBUS/EUS-B group) were included in the analysis. The sensitivities of EBUS and EBUS/EUS-B in terms of detecting N2/N3 disease were 75.0% and 79.3% respectively (p=0.698). In the EBUS/EUS-B group, only EUS-B yielded diagnostic results in two patients; the sensitivity thus increased from 72.4% to 79.3% on addition of EUS-B to EBUS. Conclusions The difference in the sensitivities of EBUS alone and EBUS/EUS-B in terms of diagnosing N2/N3 disease was not statistically significant. Although the increase in sensitivity with the addition of EUS-B is modest, it is maximised when EUS-B is used to sample lymph nodes not accessible by EBUS alone.http://openres.ersjournals.com/content/10/6/00326-2024.full
spellingShingle Masahide Oki
Hideo Saka
Yukio Seki
Yoshihito Kogure
Hideyuki Niwa
Arisa Yamada
Atsushi Torii
Chiyoe Kitagawa
Masahiko Ando
Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial
ERJ Open Research
title Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial
title_full Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial
title_fullStr Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial
title_full_unstemmed Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial
title_short Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial
title_sort utility of adding oesophageal to endobronchial endosonography when staging lung cancer a randomised trial
url http://openres.ersjournals.com/content/10/6/00326-2024.full
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