A Multicenter Feasibility Study of EBUS-TBNA for Potentially Operable Non-Small Cell Lung Cancer: The JMTO LC07-02 Study (UMIN000001280)

作者：Tanaka Fumihiro^*; Hasegawa Seiki; Kondo Nobuyuki; Miyahara Ryo; Date Hiroshi; Atagi Shinji; Kawahara Masaaki; Yamanaka Takeharu; Manabe Toshiaki; Wada Hiromi

来源：Oncology Research and Treatment, 2016, 39(10): 629-633.

DOI：10.1159/000447989

• EBUS-TBNA
• Mediastinal staging
• Minimal N2
• Surgery

Background: Endobronchial ultrasound-guided trans bronchial needle aspiration (EBUS-TBNA) is a standard procedure for the pathological evaluation of the mediastinal nodal (N2) status of lung cancer; however, its feasibility in potentially operable patients with suspicion of minimal N2 disease remains unestablished. Patients and Methods: A prospective multicenter study was conducted to assess the feasibility of EBUS-TBNA in this setting. Patients with clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) and mediastinal nodal enlargement on computed tomography (CT) were eligible; patients were ineligible when CT revealed bulky (> 3 cm in the long-axis diameter) N2 or multiple (>= 3) station N2. If EBUS-TBNA revealed negative results, surgical staging procedures were mandatory. Results: Among 20 eligible patients, EBUS-TBNA provided pathological confirmation of N2 disease (true-positive) in 12 patients. Among 8 patients with negative results with EBUS-TBNA, 4 patients were pathologically diagnosed as having N2 disease with surgical staging procedures (false-negative), and 4 were finally diagnosed as having non-N2 disease with nodal dissection by thoracotomy (true-negative). As a result, the sensitivity of EBUS-TBNA for N2 evaluation (primary endpoint) was 75.0% (95% confidence interval 47.6-92.7%). No grade 3-5 adverse event were documented. Conclusion: EBUS-TBNA is potentially safe and useful in the pathological evaluation of N2 status even in potentially operable NSCLC patients with suspicion of minimal N2 disease on preoperative CT.

• 出版日期2016-10