Cervical mediastinoscopy in diagnosis and treatment of lung cancer

Abstract

Lung cancer remains the leading cause of cancer mortality. It ranks first in the incidence of cancer in the world. According to the European Association of Oncologists, the annual incidence of lung cancer is increasing with every passing year and amounts to about 1.8 million new cases worldwide. Men have a higher prevalence of lung cancer (33.8 per 100,000) than their female counterparts (13.5 per 100,000). In most cases, it is diagnosed at an advanced stage (III — IV), which is characterised by mediastinal lymphadenopathy. Early detection of lung cancer allows seeking early treatment. Lung cancer screening is used to find a tumour and/or lung cancer metastasis, determine its location and size as well as its morphological verification. Objective — to define the most accurate invasive and non‑invasive methods of verification and diagnosis of mediastinal lymphadenopathy and improve diagnosis and treatment of lung cancer through the extensive use of cervical mediastinoscopy and creation of an algorithm for its optimal use. Materials and methods. The study included 146 patients. A wide range of clinical, laboratory, endoscopic (Endobronchial ultrasound transbronchial needle aspiration (EBUS‑TBNA), Cervical Mediastinoscopy (CM)), radiographical (Computed tomography (CT), Positron emission tomography (PET)), morphological, immunohistochemical and statistical methods were used. Statistical analysis was performed using Statistics for Windows Version 10.0 (Stat Soft Inc., USA). Results. The study involved 146 patients who underwent screening for mediastinal lymphadenopathy using mediastinoscopy. According to the laboratory findings, 98 patients had lung cancer. The rest of the cases were presented by other pathologies. Colorectal and stomach cancers were most commonly seen. In one case, the patient had a comorbidity, a combination of lung cancer and colorectal cancer. Conclusions. Mediastinoscopy is the most effective diagnostic method for mediastinal lymphadenopathy, especially in lung cancer.