The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Galkin V.N.

Moscow City Oncology Hospital No. 1

Esakov Yu.S.

Moscow City Oncology Hospital No. 1

Efteev L.A.

Moscow City Oncology Hospital No. 1

Tukvadze Z.G.

Moscow City Oncology Hospital No. 1

Bazylyuk A.V.

City Clinical Oncology Hospital No. 1

Ragimov Sh.V.

A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

Kuchevskaya O.A.

City Clinical Oncology Hospital No. 1

Invasive mediastinal staging of non-small-cell lung cancer: immediate results and a role in determining treatment policy

Authors:

Galkin V.N., Esakov Yu.S., Efteev L.A., Tukvadze Z.G., Bazylyuk A.V., Ragimov Sh.V., Kuchevskaya O.A.

More about the authors

Journal: P.A. Herzen Journal of Oncology. 2022;11(3): 5‑12

DOI: 10.17116/onkolog2022110315

Views: 745

Downloaded: 26

Download PDF (RU)
Contact the author
Table of contents

INVASIVE MEDIASTINAL STAGING OF NON-SMALL-CELL LUNG CANCER: IMMEDIATE RESULTS AND A ROLE IN DETERMINING TREATMENT POLICY
INVASIVE MEDIASTINAL STAGING OF NON-SMALL-CELL LUNG CANCER: IMMEDIATE RESULTS AND A ROLE IN DETERMINING TREATMENT POLICY

To cite this article:

Galkin VN, Esakov YuS, Efteev LA, Tukvadze ZG, Bazylyuk AV, Ragimov ShV, Kuchevskaya OA. Invasive mediastinal staging of non-small-cell lung cancer: immediate results and a role in determining treatment policy. P.A. Herzen Journal of Oncology. 2022;11(3):5‑12. (In Russ.)
https://doi.org/10.17116/onkolog2022110315

Подписка 2025-2 (P.A. Herzen Journal of Oncology)
МСФ на ЯМ
Close metadata

Lung cancer occupies leading positions in the structure of cancer morbidity and mortality. The exclusion of metastatic intrathoracic lymph nodes when staging primary non-small-cell lung cancer (NSCLC) plays an important role in terms of prognosis and determination of further treatment policy.

OBJECTIVE

To analyze the immediate results and clinical efficacy of mediastinal staging of resectable lung cancer, by using mediastinoscopy and video-assisted mediastinal lymphadenectomy (VAMLA).

MATERIAL AND METHODS

In August 2020 to December 2021, the immediate results of mediastinoscopy and VAMLA were retrospectively analyzed in 15 and 45 patients, respectively. The median age was 63 years (58; 69 years); (the age group aged 42 to 77 years); there was a male preponderance (55:5). Central cancer was detected in 24 (40%) patients. The primary tumor size varied from 8 to 107 mm with a median of 45 (32; 72) mm.

RESULTS

The median number of resected lymph nodes was 14.5 (10; 20) in the VAMLA group. Metastatic intrathoracic lymph nodes were confirmed in 20 (33.3%) of the 60 cases (95% CI 22.7-45.9%) with the affected N2, N3, and N1 collectors in 16 (26.7%), 3 (5%), and 1 (1.7%) patients, respectively. The disease stage after invasive staging and before treatment was changed in 26 (43.3%) of the 60 patients (95% CI 31.6-55.9%), with an increase or decrease in 8 (13.3%) (95% CI 6.9-24.2%) and 18 (30%) patients (95% CI 19.9-42.5%), respectively. After staging surgery, surgical treatment, chemotherapy, and chemoradiotherapy were used in 27 (45%), 31 (51.7%) and 2 (3.3%) patients, respectively. Surgical treatment was performed in 27 cases at the first stage and in 8 patients after neoadjuvant drug therapy.

CONCLUSION

Invasive mediastinal staging plays an important role in assessing the locoregional prevalence of NSCLC, allowing identification of both patients in need of combination treatment and a group of patients with primary overdiagnosis of intrathoracic lymph node involvement who can be offered radical surgical treatment.

Keywords:

lung cancer
staging
mediastinoscopy
VAMLA

Authors:

Galkin V.N.

Moscow City Oncology Hospital No. 1

Esakov Yu.S.

Moscow City Oncology Hospital No. 1

Efteev L.A.

Moscow City Oncology Hospital No. 1

Tukvadze Z.G.

Moscow City Oncology Hospital No. 1

Bazylyuk A.V.

City Clinical Oncology Hospital No. 1

Ragimov Sh.V.

A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

Kuchevskaya O.A.

City Clinical Oncology Hospital No. 1

Received:

10.02.2022

Accepted:

17.02.2022

List of references:

  1. Kaprin AD, Starinsky VV, Shakhzadova AO, eds. The state of cancer care for the population of Russia in 2019. M.: MNIOI im. P.A. Gertsena — filial FGBU «NMITs radiologii» Minzdrava Rossii; 2020. (In Russ.).
  2. Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, Znaor A, Bray F. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021 April 05.  https://doi.org/10.1002/ijc.33588
  3. Coster JN, Groth SS. Surgery for locally advanced and oligometastatic non-small cell lung cancer. Surg Oncol Clin N Am. 2020;29(4):543-554.  https://doi.org/10.1016/j.soc.2020.07.001
  4. Sergi Call, Ramon Rami-Porta. Cervical mediastinoscopy and video-assisted mediastinoscopic lymphadenectomy for the staging of non-small cell lung cancer. Mediastinum. 2019;3:31.  https://doi.org/10.21037/med.2019.07.01
  5. Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P; Members of IASLC Staging Committee. The IASLC lung cancer staging project: A proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4(5):568-577.  https://doi.org/10.1097/JTO.0b013e3181a0d82e
  6. Hürtgen M, Friedel G, Toomes H, Fritz P. Radical video-assisted mediastinoscopic lymphadenectomy (VAMLA) — technique and first results. Eur J Cardiothorac Surg. 2002;21(2):348-351.  https://doi.org/10.1016/S1010-7940(01)01125-3
  7. De Leyn P, Lardinois D, Van Schil PE, Rami-Porta R, Passlick B, Zielinski M, Waller DA, Lerut T, Weder W. ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg. 2007;32(1):1.  https://doi.org/10.1016/j.ejcts.2007.01.075
  8. De Leyn P, Dooms C, Kuzdzal J, Lardinois D, Passlick B, Rami-Porta R, Turna A, Van Schil P, Venuta F, Waller D, Weder W, Zielinski M. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;45(5):787-798.  https://doi.org/10.1016/j.ejcts.2007.01.075
  9. Al-Jahdali H, Khan AN, Loutfi S, Al-Harbi AS. Guidelines for the role of FDG-PET/CT in lung cancer management. J Infect Public Health. 2012;5(Suppl 1):35-40.  https://doi.org/10.1016/j.jiph.2012.09.003
  10. Silvestri GA, Gould MK, Margolis ML, Tanoue LT, McCrory D, Toloza E, Detterbeck F; American College of Chest Physicians. Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):178-201.  https://doi.org/10.1378/chest.07-1360
  11. Chen Z, Fillmore CM, Hammerman PS, Kim CF, Wong KK. Non-small-cell lung cancers: A heterogeneous set of diseases. Nat Rev Cancer. 2014;14(8):535-546.  https://doi.org/10.1038/nrc3775
  12. D’Andrilli A, Maurizi G, Venuta F, Rendina EA. Mediastinal staging: when and how? Gen Thorac Cardiovasc Surg. 2020;68(7):725-732.  https://doi.org/10.1007/s11748-019-01263-8
  13. Toloza EM, Harpole L, McCrory DC. Noninvasive staging of non-small cell lung cancer: A review of the current evidence. Chest. 2003;123(1 Suppl):137-146.  https://doi.org/10.1378/chest.123.1_suppl.137S
  14. Buero A, Chimondeguy DJ, Auvieux R, Lyons GA, Pankl LG, Puchulo G, Quadrelli S. Utility of PET-CT in non-small cell lung cancer clinical stage IB-IIA according to AJCC 8th edition staging system: An alternative to invasive mediastinal staging? Ecancermedicalscience. 2021;15;15:1250. https://doi.org/10.3332/ecancer.2021.1250
  15. Wang J, Welch K, Wang L, Kong FM. Negative predictive value of positron emission tomography and computed tomography for stage T1-2N0 non-small-cell lung cancer: A meta-analysis. Clin Lung Cancer. 2012;13(2):81-89.  https://doi.org/10.1016/j.cllc.2011.08.002
  16. Leiro-Fernández V, Fernández-Villar A. Mediastinal staging for non-small cell lung cancer. Transl Lung Cancer Res. 2021;10(1): 496-505.  https://doi.org/10.21037/tlcr.2020.03.08
  17. Pisters KM, Vallières E, Crowley JJ, Franklin WA, Bunn PA Jr, Ginsberg RJ, Putnam JB Jr, Chansky K, Gandara D. Surgery with or without preoperative paclitaxel and carboplatin in early-stage non-small-cell lung cancer: Southwest Oncology Group Trial S9900, an intergroup, randomized, phase III trial. J Clin Oncol. 2010;10;28(11):1843-1849. https://doi.org/10.1200/JCO.2009.26.1685
  18. Zhang X-N, Huang L. Neoadjuvant chemotherapy followed by surgery versus upfront surgery in non-metastatic non-small cell lung cancer: systematic review and meta-analysis of randomized controlled trials. Oncotarget. 2017;8:90327-90337. https://doi.org/10.18632/oncotarget.20044
  19. DeCamp MM Jr, Ashiku S, Thurer R. The role of surgery in N2 non-small cell lung cancer. Clin Cancer Res. 2005;11:5033-5037. https://doi.org/10.1158/1078-0432.CCR-05-9013
  20. Kirmani BH, Rintoul RC, Win T, Magee C, Magee L, Choong C, Wells FC, Coonar AS. Stage migration: results of lymph node dissection in the era of modern imaging and invasive staging for lung cancer. Eur J Cardiothorac Surg. 2013;43(1):104-109; discussion 109-110.  https://doi.org/10.1093/ejcts/ezz296
  21. Fernández-Villar A, Mouronte-Roibás C, Botana-Rial M, Ruano-Raviña A. Ten years of linear endobronchial ultrasound: evidence of efficacy, safety and cost-effectiveness. Arch Bronconeumol. 2016;52(2):96-102.  https://doi.org/10.1016/j.arbres.2015.08.007
  22. Maconachie R, Mercer T, Navani N, McVeigh G; Guideline Committee. Lung cancer: diagnosis and management: summary of updated NICE guidance. BMJ. 2019;364:l1049. https://doi.org/10.1136/bmj.l1049
  23. Sanz-Santos J, Serra M, Gallego M, Montón C, Cosio B, Sauleda J, Fernández-Villar A, García-Luján R, de Miguel E, Cordovilla R, Varela G, Cases E, Andreo F, Monsó E. Determinants of false-negative results in non-small-cell lung cancer staging by endobronchial ultrasound-guided needle aspiration. Eur J Cardiothorac Surg. 2015;47(4):642-647.  https://doi.org/10.1093/ejcts/ezz296
  24. Leschber G, Holinka G, Linder A. Video-assisted mediastinoscopic lymphadenectomy (VAMLA) — a method for systematic mediastinal lymphnode dissection. Eur J Cardiothorac Surg. 2003;24(2): 192-195.  https://doi.org/10.1016/s1010-7940(03)00253-7
  25. Skorokhod AA, Petrov AS, Kozak AR, Atyukov MA, Nefedov AO, Yablonskiy PK. Efficiency and safety of video-assisted mediastinal lymphadenectomy in the treatment of non-small cell lung cancer. Grekov’s Bulletin of Surgery. 2020;179(6):24-33. (In Russ.). https://doi.org/10.24884/0042-4625-2020-179-6-24-33
  26. Lozekoot P, Daemen J, van den Broek RR, Maessen JG, Gronenschild M, Vissers Y, Hulsewé K, de Loos ER. Surgical mediastinal lymph node staging for non-small-cell lung carcinoma. Transl Lung Cancer Res. 2021;10(8):3645-3658. https://doi.org/10.21037/tlcr-21-364
  27. Sayar A, Citak N, Metin M, Turna A, Pekçolaklar A, Kök A, Urer N, Celikten A, Ulukol Z N, Gürses A. Comparison of video-assisted mediastinoscopy and video-assisted mediastinoscopic lymphadenectomy for lung cancer. Gen Thorac Cardiovasc Surg. 2011;59(12):793-798.  https://doi.org/10.1007/s11748-011-0819-8
  28. Call S, Obiols C, Rami-Porta R, Trujillo-Reyes JC, Iglesias M, Saumench R, Gonzalez-Pont G, Serra-Mitjans M, Belda-Sanchís J. Video-assisted mediastinoscopic lymphadenectomy for staging non-small cell lung cancer. Ann Thorac Surg. 2016;101(4):1326-1333. https://doi.org/10.1016/j.athoracsur.2015.10.073

Close metadata

Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.