Lung cancer Staging

a b s t r a c t The main purpose of staging in non-small cell lung cancer (NSCLC) is to assess mediastinal lymph node involvement, with thoracic CT being themain non-invasive test for this. However, given that up to 15 % of patients who show nomediastinal lymph node involvement in the CT has lymph nodemetastasis during surgery, other examinations are required. Endoscopic ultrasonography guided fine-needle aspiration (EUS-FNA)was shown tobeable todetect advanceddisease (metastaticmediastinal lymphnodes, adrenal metastasis, mediastinal invasion by the tumor) in approximately 25 % of patientswith a CT that suggested a non-advanced disease. Another situation in which CT has a very limited value is in the evaluation of the response to induction therapy, with its most limiting factor being its intrinsic inability to distinguish between a tumor and necrosis. In this context, EUS-FNA was shown to have a good performance, with a sensitivity, negative predictive value and precision of 75%, 67%, and 83%, respectively. In conclusion, EUS-FNA may be considered a good alternative in the pre-operative staging of patients with NSCLC, with andwithout diseasedmediastinal lymph nodes in CT, and could play an important role in themediastinal re-staging of these patients by identifying a patient sub-groupwhomight benefit from additional surgical treatment. © 2011 SEPAR. Published by Elsevier España, S.L. All rights reserved. Nuevas aplicaciones de la ultrasonografía endoscópica (USE) en el cáncer de pulmón: evaluación de pacientes con mediastino negativo por TC y reestadificación después de tratamiento neoadyuvante Palabras clave: Cáncer de pulmó