Less Invasive Way to Stage Lung Cancer Shows Promise

EBUS-FNA was more sensitive (meaning it picked up more malignancies) than TBNA, detecting 69 percent of malignant lymph nodes versus 36 percent.

The combination of EBUS-FNA and EUS-FNA had 93 percent estimated sensitivity and a 97 percent negative predictive value (proportion of patients with negative results who are actually negative), compared with either method used alone.

The combination, which had both higher sensitivity and higher negative predictive value, may be a substitute for current, invasive techniques, the authors stated.

If mediastinoscopy had been done only when the combination results were negative, the more invasive surgical procedure would have been avoided in 28 percent of patients, the study showed.

If the combination had completely replaced mediastinoscopy, 97 percent would have been correctly labeled as negative.

"It is really focused on less invasive ways to stage the cancers as opposed to earlier detection methods, but it allows us to better select patients who will benefit from surgery to do it in a less invasive way and, importantly, to avoid surgical procedures in patients where the tumor has already spread who wouldn't benefit from the surgery," Wallace said.

Wallace reported that he had received research grants from different makers of equipment relevant to endoscopic ultrasound.

More information

The American Lung Association has more on lung cancer.

SOURCES: Michael B. Wallace, M.D., professor, medicine, Mayo Clinic College of Medicine, Jacksonville, Fla.; Norman Edelman, M.D., chief medical officer, American Lung Association; Feb. 6, 2008,Journal of the American Medical Association