Computed tomography and mediastinoscopy in preoperative N-staging of non-small cell lung cancer
The aim of our study was to compare the diagnostic value of computed tomography (CT) and standard mediastinoscopy (SM) in N-staging of non-small cell lung cancer (NSCLC). 278 patients with NSCLC were included and divided into 2 groups: in group I both chest CT and SM were used, whereas in group II only chest CT was used for preoperative N-staging. Diagnostic value was higher for mediastinoscopy than for CT: specificity - 100 % vs 69 %; sensitivity - 72 % vs 59 %, accuracy 91 % vs 66 %; (p < 0,05). The incidence of unforseen N2/N3 was significantly higher in group II (29 %) than in group I (11 %). We conclude that N-staging with CT as the only method is inadequate because of poor sensitivity and specificity of CT, whereas SM has high diagnostic value in staging of NSCLC and provides excellent accuracy when maximum number of mediastinal lymphnodes are biopsied during the procedure.