Minimally Invasive Methods for Staging in Lung Cancer: Systematic Review and Meta-Analysis
Mehta, Hiren J.
Jantz, Michael A.
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CitationLabarca, Gonzalo, Carlos Aravena, Francisco Ortega, Alex Arenas, Adnan Majid, Erik Folch, Hiren J. Mehta, Michael A. Jantz, and Sebastian Fernandez-Bussy. 2016. “Minimally Invasive Methods for Staging in Lung Cancer: Systematic Review and Meta-Analysis.” Pulmonary Medicine 2016 (1): 1024709. doi:10.1155/2016/1024709. http://dx.doi.org/10.1155/2016/1024709.
AbstractIntroduction:. Endobronchial ultrasound (EBUS) is a procedure that provides access to the mediastinal staging; however, EBUS cannot be used to stage all of the nodes in the mediastinum. In these cases, endoscopic ultrasound (EUS) is used for complete staging. Objective. To provide a synthesis of the evidence on the diagnostic performance of EBUS + EUS in patients undergoing mediastinal staging. Methods. Systematic review and meta-analysis to evaluate the diagnostic yield of EBUS + EUS compared with surgical staging. Two researchers performed the literature search, quality assessments, data extractions, and analyses. We produced a meta-analysis including sensitivity, specificity, and likelihood ratio analysis. Results. Twelve primary studies (1515 patients) were included; two were randomized controlled trials (RCTs) and ten were prospective trials. The pooled sensitivity for combined EBUS + EUS was 87% (CI 84–89%) and the specificity was 99% (CI 98–100%). For EBUS + EUS performed with a single bronchoscope group, the sensitivity improved to 88% (CI 83.1–91.4%) and specificity improved to 100% (CI 99-100%). Conclusion. EBUS + EUS is a highly accurate and safe procedure. The combined procedure should be considered in selected patients with lymphadenopathy noted at stations that are not traditionally accessible with conventional EBUS.
Citable link to this pagehttp://nrs.harvard.edu/urn-3:HUL.InstRepos:29626121
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