Lung cancer patients with small nodes on CT - What's the next step?

Abstract

In summary, for accurate mediastinal evaluation of NSCLC patients with small nodes at chest CT further staging is needed. The choice of the additional staging test(s) will depend on the access to novel methods, experience with specific techniques and patient related factors such as the localisation of the primary tumour. Either PET and/or EUS-FNA qualifies best as the initial diagnostic procedure, whereas EBUS-TBNA is a third promising alternative. The role of mediastinoscopy remains important as a second procedure after negative E(B)US findings and in those hospitals without access to either PET or E(B)US. Further studies are urgently needed in order to define an optimal staging strategy for this large subset of patients with non-small cell lung cancer and small nodes. © Georg Thieme Verlag KG Stuttgart.