微创与最大收益:非小细胞肺癌纵隔淋巴结分期的当前实践综述》。

IF 1.1 4区 医学 Q3 SURGERY
Gustavo R Rodriguez, Gregory D Trachiotis, Philip S Mullenix, Jared L Antevil
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引用次数: 0

摘要

背景:在美国,肺癌仍然是导致癌症死亡的主要原因,尽管由于早期检测的进步和新型疗法的开发,肺癌的发病率有所下降,治疗效果也有所改善。准确的纵隔淋巴结分期对于确定预后和指导治疗决策至关重要,尤其是非小细胞肺癌(NSCLC)。材料与方法:对PubMed进行系统检索,以确定2010年1月至2024年1月期间发表的以成人NSCLC患者术前淋巴结分期为重点的英文文章。纳入了病例系列、观察性研究、随机试验、指南、叙事性综述、系统性综述和荟萃分析。结果:综述了用于纵隔淋巴结分期的各种成像模式、手术和非手术疗法,包括正电子发射计算机断层扫描、颈纵隔镜检查、视频辅助颈纵隔镜检查、前纵隔切开术、前纵隔切开术、视频辅助胸腔镜检查、支气管内超声引导下细针穿刺术(EBUS-FNA)、经食道内镜超声引导下细针穿刺术(EUS-FNA)和计算机断层扫描引导下经皮淋巴结活检术。EBUS-FNA 灵敏度高、并发症发生率低,因此成为首选的初始分期手术。将其与其他程序或确诊检查相结合,可能有助于确定适当的治疗方法。结论:尽管颈纵隔镜检查在特定病例中仍是一种有价值的确诊方法,但随着EBUS-FNA和EUS-FNA的广泛应用,其作为一线分期方法的作用正在减弱。EBUS-FNA 和 EUS-FNA 的联合应用几乎可以检查到所有纵隔淋巴结站,诊断准确率极高。未来的研究可能会进一步完善有创纵隔分期手术的选择标准,最终优化 NSCLC 患者的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Minimally Invasive with Maximal Yield: A Narrative Review of Current Practices in Mediastinal Lymph Node Staging in Non-Small Cell Lung Cancer.

Background: Lung cancer remains the leading cause of cancer deaths in the United States despite declining incidence and improved outcomes because of advancements in early detection and development of novel therapies. Accurate mediastinal lymph node staging is crucial for determining prognosis and guiding treatment decisions, particularly for non-small cell lung cancer (NSCLC). Materials and Methods: A systematic search of PubMed was conducted to identify English language articles published between January 2010 and January 2024 focusing on preoperative lymph node staging in adults with NSCLC. Case series, observational studies, randomized trials, guidelines, narrative reviews, systematic reviews, and meta-analyses were included. Results: Various imaging modalities, surgical and nonsurgical procedures for mediastinal lymph node staging were reviewed, including positron emission tomography with computed tomography, cervical mediastinoscopy, video-assisted cervical mediastinoscopy, anterior mediastinotomy, video-assisted thoracoscopy, endobronchial ultrasound-guided fine needle aspiration (EBUS-FNA), transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), and computed tomography-guided percutaneous lymph node biopsy. EBUS-FNA emerged as the preferred initial staging procedure because of its high sensitivity and low complication rate. Combining it with other procedures or confirmatory testing may be helpful in determining appropriate treatment. Conclusions: Although cervical mediastinoscopy remains a valuable confirmatory procedure in select cases, its role as a first-line staging modality is diminishing with the widespread adoption of EBUS-FNA and EUS-FNA. The combination of EBUS-FNA and EUS-FNA allows access to nearly all mediastinal lymph node stations with high diagnostic accuracy. Future research may further refine the selection criteria for invasive mediastinal staging procedures, ultimately optimizing patient outcomes in the management of NSCLC.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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