Diagnostic Yield of Endobronchial Ultrasound-Guided Fine Needle Aspiration (EBUS-FNA) in Lung Cancer Staging, Subtyping and Diagnosis of Unexplained Mediastinal Lymphadenopathy

INTRODUCTION Lung cancer (LC) is the most commonly diagnosed cancer worldwide and the most frequent cause of cancer death in both men and women in the US (more deaths than the next three most common cancers combined)1 Clinical staging of LC is an integral part of patient care because it directs therapy and has prognostic value Patients are routinely investigated with a conventional workup (medical history, PE, lab tests, bronchoscopy), CT and integrated whole-body PET-CT, followed by mediastinal tissue staging for enlarged or PET-positive intrathoracic nodes2 Mediastinal tissue staging has been classically performed by mediastinoscopy, but they can also be sampled under real-time ultrasound control from the airways (endobronchial ultra-sound guided fine needle aspiration [EBUS-FNA]). Current lung cancer staging guidelines acknowledge endosonography as a minimally invasive alternative to surgical staging to detect nodal disease,3,4 reducing the need for surgical staging in up to two thirds of patients5,6 The purpose of this study was to evaluate the diagnostic yield of EBUS-FNA for accurate lung cancer staging, subtyping and assessment of mediastinal lymphadenopath