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Inaccurate clinical nodal staging of non-small cell lung cancer: evidence from the MRC LU22 multicentre randomised trial
  1. N Navani1,
  2. M Nankivell1,
  3. R J Stephens1,
  4. M K B Parmar1,
  5. D Gilligan2,
  6. M Nicolson3,
  7. H J M Groen4,
  8. J P van Meerbeeck5
  1. 1MRC Clinical Trials Unit, London, UK
  2. 2Addenbrooke's Hospital, Cambridge, UK
  3. 3Aberdeen Royal Hospitals Trust, Aberdeen, UK
  4. 4University Hospital, Groningen, The Netherlands
  5. 5University Hospital, Ghent, Belgium
  1. Correspondence to Dr N Navani, MRC Clinical Trials Unit, 222 Euston Road, London NW1 2DA, UK; nn{at}

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The clinical staging of non-small cell lung cancer (NSCLC) is of paramount importance. It determines prognosis and therapy, and inaccurate staging may result in inappropriate treatment. In particular, clinical staging that misses mediastinal metastases may result in the patient undergoing a futile thoracotomy. Conversely, accurately detecting mediastinal metastases preoperatively would allow consideration of concurrent chemoradiotherapy or neoadjuvant treatment.

Although sensitivity and specificity data of CT scanning, positron emission tomography (PET) and mediastinoscopy for the detection of mediastinal metastases exist, the impact on patient outcomes when combined with other standard staging techniques such as mediastinoscopy is limited. The MRC LU22 trial,1 which compared surgery alone with neoadjuvant chemotherapy followed by surgery, collected prospective data on clinical and pathological staging …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.