© 2002 Thorax
EDITORIAL
Endoscopic ultrasound
Endoscopic ultrasound: a useful tool to assess the mediastinum in patients with lung cancer?
Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK
Correspondence to:
Correspondence to:
Dr R J Fergusson;
ron.fergusson@luht.scot.nhs.uk
EUS-FNA may help to diagnose the spread of lesions to the mediastinum in patients with lung cancer.
Keywords: endoscopic ultrasound; mediastinum; fine needle aspiration; lung cancer
Mediastinal involvement either by direct invasion or by spread to lymph nodes is seen at diagnosis in up to 50% of patients with non-small cell lung cancer and has a significant impact on both treatment and prognosis. Ipsilateral or subcarinal lymph node involvement (N2 disease) is associated with a 5 year survival of 7–13%1 and usually precludes resection, but may identify a subset of patients who might benefit from neoadjuvant therapy. Contralateral nodal disease (N3) is surgically incurable with fewer than 5% of patients surviving 5 years. Accurate assessment of the mediastinum at the time of diagnosis is therefore vital for patients deemed suitable for potentially curative treatment.
To date, computed tomographic (CT) scanning remains the mainstay of imaging the mediastinum but it has limited sensitivity and specificity for detecting nodal involvement. Enlarged benign reactive nodes are frequently present in patients with a lung primary and, conversely, micrometastasis
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