Endosonography with lymph node sampling for restaging the mediastinum in lung cancer: A systematic review and pooled data analysis

AME Lung Cancer Collaborative Group

Research output: Contribution to journalArticle

Abstract

Background: Mediastinal restaging after induction treatment is still a difficult and controversial issue. We aimed to investigate the diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration for restaging the mediastinum after induction treatment in patients with lung cancer. Methods: Embase and PubMed databases were searched from conception to March 2019. Data from relevant studies were analyzed to assess sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration, and to fit the hierarchical summary receiver operating characteristic curves. Results: A total of 10 studies consisting of 558 patients fulfilled the inclusion criteria. All patients were restaged by endobronchial ultrasound-guided transbronchial needle aspiration, endoscopic ultrasound-guided fine-needle aspiration, or both. Negative results were confirmed by subsequent surgical approaches. There were no complications reported during any endosonography approaches reviewed. The pooled sensitivities of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration were 65% (95% confidence interval [CI], 52-76) and 73% (95% CI, 52-87), respectively, and specificities were 99% (95% CI, 78-100) and 99% (95% CI, 90-100), respectively. The area under the hierarchical summary receiver operating characteristic curves were 0.85 (95% CI, 0.81-0.88) for endobronchial ultrasound-guided transbronchial needle aspiration and 0.99 (95% CI, 0.98-1) for endoscopic ultrasound-guided fine-needle aspiration. Moreover, for patients who received chemotherapy alone, the pooled sensitivity of endosonography with lymph node sampling for restaging was 66% (95% CI, 56-75), and specificity was 100% (95% CI, 34-100); for patients who received chemoradiotherapy, the results seemed similar with a sensitivity of 77% (95% CI, 47-92) and specificity of 99% (95% CI, 48-100). Conclusions: Endosonography with lymph node sampling is an accurate and safe technique for mediastinal restaging of lung cancer.

Original languageEnglish (US)
JournalJournal of Thoracic and Cardiovascular Surgery
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Endosonography
Mediastinum
Lung Neoplasms
Lymph Nodes
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Confidence Intervals
Needles
ROC Curve
Chemoradiotherapy
PubMed
Databases
Drug Therapy
Sensitivity and Specificity

Keywords

  • EBUS
  • EUS
  • fine-needle aspiration
  • lung cancer
  • mediastinal restaging

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

@article{3db268e631544700951fbe16f0a0bcfe,
title = "Endosonography with lymph node sampling for restaging the mediastinum in lung cancer: A systematic review and pooled data analysis",
abstract = "Background: Mediastinal restaging after induction treatment is still a difficult and controversial issue. We aimed to investigate the diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration for restaging the mediastinum after induction treatment in patients with lung cancer. Methods: Embase and PubMed databases were searched from conception to March 2019. Data from relevant studies were analyzed to assess sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration, and to fit the hierarchical summary receiver operating characteristic curves. Results: A total of 10 studies consisting of 558 patients fulfilled the inclusion criteria. All patients were restaged by endobronchial ultrasound-guided transbronchial needle aspiration, endoscopic ultrasound-guided fine-needle aspiration, or both. Negative results were confirmed by subsequent surgical approaches. There were no complications reported during any endosonography approaches reviewed. The pooled sensitivities of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration were 65{\%} (95{\%} confidence interval [CI], 52-76) and 73{\%} (95{\%} CI, 52-87), respectively, and specificities were 99{\%} (95{\%} CI, 78-100) and 99{\%} (95{\%} CI, 90-100), respectively. The area under the hierarchical summary receiver operating characteristic curves were 0.85 (95{\%} CI, 0.81-0.88) for endobronchial ultrasound-guided transbronchial needle aspiration and 0.99 (95{\%} CI, 0.98-1) for endoscopic ultrasound-guided fine-needle aspiration. Moreover, for patients who received chemotherapy alone, the pooled sensitivity of endosonography with lymph node sampling for restaging was 66{\%} (95{\%} CI, 56-75), and specificity was 100{\%} (95{\%} CI, 34-100); for patients who received chemoradiotherapy, the results seemed similar with a sensitivity of 77{\%} (95{\%} CI, 47-92) and specificity of 99{\%} (95{\%} CI, 48-100). Conclusions: Endosonography with lymph node sampling is an accurate and safe technique for mediastinal restaging of lung cancer.",
keywords = "EBUS, EUS, fine-needle aspiration, lung cancer, mediastinal restaging",
author = "{AME Lung Cancer Collaborative Group} and Long Jiang and Weizhe Huang and Jun Liu and Kassem Harris and Lonny Yarmus and Wenlong Shao and Hanzhang Chen and Wenhua Liang and Jianxing He",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jtcvs.2019.07.095",
language = "English (US)",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Endosonography with lymph node sampling for restaging the mediastinum in lung cancer

T2 - A systematic review and pooled data analysis

AU - AME Lung Cancer Collaborative Group

AU - Jiang, Long

AU - Huang, Weizhe

AU - Liu, Jun

AU - Harris, Kassem

AU - Yarmus, Lonny

AU - Shao, Wenlong

AU - Chen, Hanzhang

AU - Liang, Wenhua

AU - He, Jianxing

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Mediastinal restaging after induction treatment is still a difficult and controversial issue. We aimed to investigate the diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration for restaging the mediastinum after induction treatment in patients with lung cancer. Methods: Embase and PubMed databases were searched from conception to March 2019. Data from relevant studies were analyzed to assess sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration, and to fit the hierarchical summary receiver operating characteristic curves. Results: A total of 10 studies consisting of 558 patients fulfilled the inclusion criteria. All patients were restaged by endobronchial ultrasound-guided transbronchial needle aspiration, endoscopic ultrasound-guided fine-needle aspiration, or both. Negative results were confirmed by subsequent surgical approaches. There were no complications reported during any endosonography approaches reviewed. The pooled sensitivities of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration were 65% (95% confidence interval [CI], 52-76) and 73% (95% CI, 52-87), respectively, and specificities were 99% (95% CI, 78-100) and 99% (95% CI, 90-100), respectively. The area under the hierarchical summary receiver operating characteristic curves were 0.85 (95% CI, 0.81-0.88) for endobronchial ultrasound-guided transbronchial needle aspiration and 0.99 (95% CI, 0.98-1) for endoscopic ultrasound-guided fine-needle aspiration. Moreover, for patients who received chemotherapy alone, the pooled sensitivity of endosonography with lymph node sampling for restaging was 66% (95% CI, 56-75), and specificity was 100% (95% CI, 34-100); for patients who received chemoradiotherapy, the results seemed similar with a sensitivity of 77% (95% CI, 47-92) and specificity of 99% (95% CI, 48-100). Conclusions: Endosonography with lymph node sampling is an accurate and safe technique for mediastinal restaging of lung cancer.

AB - Background: Mediastinal restaging after induction treatment is still a difficult and controversial issue. We aimed to investigate the diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration for restaging the mediastinum after induction treatment in patients with lung cancer. Methods: Embase and PubMed databases were searched from conception to March 2019. Data from relevant studies were analyzed to assess sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration, and to fit the hierarchical summary receiver operating characteristic curves. Results: A total of 10 studies consisting of 558 patients fulfilled the inclusion criteria. All patients were restaged by endobronchial ultrasound-guided transbronchial needle aspiration, endoscopic ultrasound-guided fine-needle aspiration, or both. Negative results were confirmed by subsequent surgical approaches. There were no complications reported during any endosonography approaches reviewed. The pooled sensitivities of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound-guided fine-needle aspiration were 65% (95% confidence interval [CI], 52-76) and 73% (95% CI, 52-87), respectively, and specificities were 99% (95% CI, 78-100) and 99% (95% CI, 90-100), respectively. The area under the hierarchical summary receiver operating characteristic curves were 0.85 (95% CI, 0.81-0.88) for endobronchial ultrasound-guided transbronchial needle aspiration and 0.99 (95% CI, 0.98-1) for endoscopic ultrasound-guided fine-needle aspiration. Moreover, for patients who received chemotherapy alone, the pooled sensitivity of endosonography with lymph node sampling for restaging was 66% (95% CI, 56-75), and specificity was 100% (95% CI, 34-100); for patients who received chemoradiotherapy, the results seemed similar with a sensitivity of 77% (95% CI, 47-92) and specificity of 99% (95% CI, 48-100). Conclusions: Endosonography with lymph node sampling is an accurate and safe technique for mediastinal restaging of lung cancer.

KW - EBUS

KW - EUS

KW - fine-needle aspiration

KW - lung cancer

KW - mediastinal restaging

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U2 - 10.1016/j.jtcvs.2019.07.095

DO - 10.1016/j.jtcvs.2019.07.095

M3 - Article

AN - SCOPUS:85072635243

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

ER -