ArticleThe Journal of thoracic and cardiovascular surgery2019
Invasive mediastinal staging for resected non-small cell lung cancer in a population-based cohort.
Article in The Journal of thoracic and cardiovascular surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Survival After Mediastinal Node Dissection, Systematic Sampling, or Neither for Early Stage NSCLC.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2020Pooled it
- Systematic Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) Compared with Targeted EBUS-TBNA for Mediastinal Staging of Locally Advanced Non-small Cell Lung Cancer.Annals of surgical oncology · 2026Article
- Balancing Accuracy, Safety, and Cost in Mediastinal Diagnostics: A Systematic Review of EBUS and Mediastinoscopy in NSCLC.Healthcare (Basel, Switzerland) · 2025Review
- Three-Dimensional Printed Model of the Mediastinum for Cardiothoracic Surgery Resident Education.Annals of thoracic surgery short reports · 2025Article
- Article
- Clinical utility of artificial intelligence-augmented endobronchial ultrasound elastography in lymph node staging for lung cancer.JTCVS techniques · 2024Article
- Predicting lymph node metastasis of clinical T1 non-small cell lung cancer: a brief review of possible methodologies and controversies.Frontiers in oncology · 2024Review
- Surgeon Quality and Patient Survival After Resection for Non-Small-Cell Lung Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Analysis of predictive factors of unforeseen nodal metastases in resected clinical stage I NSCLC.Frontiers in oncology · 2023Article
- Predicting Malignant Lymph Nodes Using a Novel Scoring System Based on Multi-Endobronchial Ultrasound Features.Cancers · 2022Article
- Rates of Guideline-Concordant Surgery and Adjuvant Chemotherapy Among Patients With Early-Stage Lung Cancer in the US ALCHEMIST Study (Alliance A151216).JAMA oncology · 2022Article
- Article
- Institutional-Level Differences in Quality and Outcomes of Lung Cancer Resections in the United States.Chest · 2021Article
- Mediastinal staging for non-small cell lung cancer.Translational lung cancer research · 2021Review
- Extended resections and other special cases in lung cancer surgery: Real-world population-based outcomes.Thoracic cancer · 2020Article
- Quantitative analysis of endobronchial ultrasound elastography in computed tomography-negative mediastinal and hilar lymph nodes.Thoracic cancer · 2020Article
- Rurality, Stage-Stratified Use of Treatment Modalities, and Survival of Non-small Cell Lung Cancer.Chest · 2020Article
- Mediastinal staging: when and how?General thoracic and cardiovascular surgery · 2020Review
- Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and Mediastinoscopy.Chest · 2020Article
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6 authors at 1 institution in 1 country.
Funding
Abstract
objectivesInvasive mediastinal nodal staging is recommended before curative-intent resection in patients with non-small cell lung cancer deemed at risk for mediastinal lymph node involvement. We evaluated the use and survival effect of preoperative invasive mediastinal nodal staging in a population-based non-small cell lung cancer cohort.
methodsWe analyzed all curative-intent resections for non-small cell lung cancer from 2009 to 2018 in 11 hospitals in 4 contiguous Dartmouth Hospital Referral Regions, comparing patients who did not have invasive mediastinal nodal staging with those who did.
resultsPreoperative invasive nodal staging was used in 22% of 2916 patients, including mediastinoscopy only in 13%, minimally invasive procedures only in 6%, and both approaches in 3%. Sixty-three percent of patients at risk for nodal disease (tumor size ≥3.0 cm/T2-T4; N1-N3 by computed tomography or positron-emission tomography-computerized tomography criterion) did not undergo invasive staging; among those who did not have invasive testing, 47% had at least 1 of the 3 clinical indications. Mediastinoscopy yielded a median of 3 lymph nodes and 2 nodal stations; 17% of mediastinoscopies and 31% of endobronchial ultrasound procedures yielded no lymph node material. Patients not invasively staged were more likely to have no nodes (6% vs 2%; P < .0001) and no mediastinal nodes (20% vs 11%; P < .0001) examined at surgery. Invasive staging was associated with significantly better survival (P = .0157).
conclusionsMore than a decade after the 2001 American College of Surgeons Patient Care Evaluation report, preoperative invasive nodal staging remains underused and of variable quality, but was associated with survival benefit in high-risk patients.
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