Evidence map›Paper›PMID 37627057›Full record

ArticleCancers2023

Endobronchial Ultrasound/Transbronchial Needle Aspiration-Biopsy for Systematic Mediastinal lymph Node Staging of Non-Small Cell Lung Cancer in Patients Eligible for Surgery: A Prospective Multicenter Study.

Duilio Divisi, Gabriella Di Leonardo, Massimiliano Venturino, Elisa Scarnecchia, Alessandro Gonfiotti, Domenico Viggiano, Marco Lucchi, Maria Giovanna Mastromarino, Alessandro Bertani, Roberto Crisci

Open access · goldAbstract read
In one paragraph

Article in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Duilio DivisiDepartment of Life, Health and Environmental Sciences, Thoracic Surgery Unit, University of L'Aquila, 67100 L'Aquila, Italy.ORCID 0000-0002-8137-7533
Gabriella Di LeonardoDepartment of Life, Health and Environmental Sciences, Thoracic Surgery Unit, University of L'Aquila, 67100 L'Aquila, Italy.
Massimiliano VenturinoDepartment of Thoracic Surgery, Cuneo General Hospital, 12100 Cuneo, Italy.
Elisa ScarnecchiaDepartment of Thoracic Surgery, Cuneo General Hospital, 12100 Cuneo, Italy.ORCID 0000-0003-3817-1852
Alessandro GonfiottiThoracic Surgery Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy.ORCID 0000-0003-2724-9474
Domenico ViggianoThoracic Surgery Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy.
Marco LucchiDivision of Thoracic Surgery, University Hospital of Pisa, 56124 Pisa, Italy.ORCID 0000-0001-9909-6820
Maria Giovanna MastromarinoDivision of Thoracic Surgery, University Hospital of Pisa, 56124 Pisa, Italy.
Alessandro BertaniDivision of Thoracic Surgery and Lung Transplantation, IRCCS ISMETT-UPMC, 90127 Palermo, Italy.ORCID 0000-0003-1684-3259
Roberto CrisciDepartment of Life, Health and Environmental Sciences, Thoracic Surgery Unit, University of L'Aquila, 67100 L'Aquila, Italy.ORCID 0000-0002-4882-5330
University of L'Aquila · ITAzienda Ospedaliera Universitaria Pisana · ITAzienda Sanitaria Ospedaliera S.Croce e Carle Cuneo · ITUniversity of Florence · ITIstituti di Ricovero e Cura a Carattere Scientifico · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe treatment of lung cancer depends on histological and/or cytological evaluation of the mediastinal lymph nodes. Endobronchial ultrasound/transbronchial needle aspiration-biopsy (EBUS/TBNA-TBNB) is the only minimally invasive technique for a diagnostic exploration of the mediastinum. The aim of this study is to analyze the reliability of EBUS in the preoperative staging of non-small cell lung cancer (NSCLC).

methodsA prospective study was conducted from December 2019 to December 2022 on 217 NSCLC patients, who underwent preoperative mediastinal staging using EBUS/TBNA-TBNB according to the ACCP and ESTS guidelines. The following variables were analyzed in order to define the performance of the endoscopic technique-comparing the final staging of lung cancer after pulmonary resection with the operative histological findings: clinical characteristics, lymph nodes examined, number of samples, and likelihood ratio for positive and negative outcomes.

resultsNo morbidity or mortality was noted. All patients were discharged from hospital on day one. In 201 patients (92.6%), the preoperative staging using EBUS and the definitive staging deriving from the evaluation of the operative specimen after lung resection were the same; the same number of patients were detected in downstaging and upstaging (8 and 8, 7.4%). The sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were 90%, 90%, 82%, 94%, and 90%, respectively. The likelihood ratio for positive and negative results was 9 and 0.9, respectively, confirming cancer when present and excluding it when absent.

conclusionsEBUS is the only low-invasive and easy procedure for mediastinal staging. The possibility to check the method in each of its phases-through direct visualization of the vessels regardless of their location in relation to the lymph nodes-makes it safe both for the endoscopist and for the patient. Certainly, the cytologist/histologist and/or operator must have adequate expertise in order not to negatively affect the outcome of the method, although three procedures appear to reduce the impact of the individual professional involved on performance.

Indexed as

mediastinal stagingNSCLCultrasonography of the mediastinum

Identifiers

PMID37627057
PMCPMC10452056
OpenAlexW4385708288

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.