2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.05A.03 The Accuracy of EBUS, EUS, EBUS Plus EUS, and Mediastinoscopy for Mediastinal Staging in NSCLC

EP.05A.03 The Accuracy of EBUS, EUS, EBUS Plus EUS, and Mediastinoscopy for Mediastinal Staging in NSCLC - A Systematic Review and Meta-Analysis

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The abstract summarizes a systematic review and meta-analysis that compares the accuracy of different methods for mediastinal staging of non-small cell lung cancer (NSCLC): Endobronchial Ultrasound (EBUS), Endoscopic Ultrasound (EUS), a combination of EBUS and EUS (EBUSEUS), and mediastinoscopy. Conducted by a Brazilian research team, the study aims to optimize therapy and improve outcomes by identifying the most accurate method. According to the study, lung cancer is a leading cause of cancer-related deaths, and accurate staging is critical for effective treatment. <br /><br />The analysis involved the evaluation of various diagnostic metrics such as sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). Data were collected from several databases with quality assessed using the GRADE system. The pooled sensitivity and specificity were reported for each method, with EBUS showing a sensitivity of 0.83 and a specificity of 0.99, while EUS showed 0.80 and 0.97, respectively. Mediastinoscopy's pooled sensitivity was 0.80, with specificity also at 0.99. EBUSEUS showed the highest sensitivity among the techniques at 0.87.<br /><br />The study concludes that EBUS-TBNA combined with EUS-FNA is recommended for accurately assessing mediastinal lymph nodes, presenting a sensitivity and specificity comparable to that of mediastinoscopy. However, availability may be limited to specialized tertiary care centers due to required expertise and equipment. While mediastinoscopy is traditional, its accessibility to certain lymph node regions is limited. The study acknowledges support from various institutions and pharmaceutical companies. The findings highlight the potential of EBUSEUS as a minimally invasive, outpatient procedure that may serve as an effective alternative for lung cancer staging in appropriately equipped healthcare settings.

Asset Subtitle

Ana Gelatti

Meta Tag

Speaker Ana Gelatti

Topic Pulmonology and Staging

Keywords

NSCLC

mediastinal staging

EBUS

EUS

EBUSEUS

mediastinoscopy

lung cancer

diagnostic accuracy

sensitivity

specificity