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Research paper (original)
Published online: 2025-02-20
Added value of combined endobronchial and endoscopic ultrasound-guided needle biopsy in mediastinal staging of lung cancer
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Abstract
Introduction. Data on the added value of combined endobronchial and endoscopic ultrasound (CUS) following staging with imaging studies are limited. This study aimed to analyze the rates of upstaging and downstaging on CUS.
Material and methods. This retrospective cohort study evaluated lung cancer patients who underwent computed tomography (CT), positron emission tomography (PET), and CUS.
Results. 858 patients were evaluated. The PET-based N2 status was upstaged and downstaged on CUS in 54 (6.3%) and 347 (40.4%) patients, respectively. The PET-based factors T1c–T2b, T4, and N1 were associated with N2 upstaging. Tumor grades 2, 3, and 4; male sex; right lower lobe location; adenocarcinoma and carcinoid histologies; and the PET-based factors T2a–T3, and N2 were associated with N2 downstaging.
Conclusions. PET-based N1 involvement is strongly associated with the probability of N2 upstaging. High tumor grade, male sex, and the PET-based factors T3–4 and N2 are strongly associated with the probability of N2 downstaging.
Keywords: lung cancerstagingPETEBUSEUS
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