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An International Survey of Mediastinal Staging Practices amongst Interventional Bronchoscopists.
Guinde, Julien; Roy, Pascalin; Dutau, Hervé; Musani, Ali; Quadrelli, Silvia; Stratakos, Grigoris; Vergnon, Jean-Michel; Tremblay, Alain; Fortin, Marc.
Afiliação
  • Guinde J; Department of Pulmonology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, Québec, Canada, JULIEN.GUINDE@ap-hm.fr.
  • Roy P; Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Marseille, France, JULIEN.GUINDE@ap-hm.fr.
  • Dutau H; Department of Pulmonology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, Québec, Canada.
  • Musani A; Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Marseille, France.
  • Quadrelli S; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Denver, Colorado, USA.
  • Stratakos G; Department of Respiratory Medicine, Güemes Foundation, Buenos Aires, Argentina.
  • Vergnon JM; 1st Respiratory Medicine Department, Sotiria Hospital, University of Athens, Athens, Greece.
  • Tremblay A; Département de Pneumologie et Oncologie Thoracique, Saint-Etienne, France.
  • Fortin M; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Respiration ; 99(6): 508-515, 2020.
Article em En | MEDLINE | ID: mdl-32485718
INTRODUCTION: In potentially curable non-small-cell lung cancer, different practice guidelines recommend invasive me-diastinal staging in tumors larger than 3 cm, central, or hy-permetabolic N1 lymph nodes. There is no consensus concerning the use of an endosonographic procedure or a mediastinoscopy in the first line in patients with a radiologically normal mediastinum, while in case of a mediastinal involvement, the latest European guidelines recommend the combination of endobronchial ultrasound (EBUS) and endoscopic ultrasound/endoscopic ultrasound with EBUS endoscope (EUS/EUS-B), using a systematic endosonographic procedure. This international survey was conducted to describe current medical practices in endoscopic mediastinal staging amongst interventional bronchoscopists. METHODS: A survey was developed and sent to all members of different interventional pulmonology societies, with the purpose to describe who, when and how an endoscopic mediastinal staging was performed. RESULTS: One hundred and fifty-three bronchoscopists responded to the survey. Most of them practiced in Europe (n = 84, 55%) and North America (n = 52, 34%). In the first line, EBUS alone was the most widely used endoscopic procedure for mediastinal staging. Half of the responders performed a systematic endoscopic staging procedure, including a systematic examination of all accessible nodal stations and a sampling of all lymph nodes >5 mm in the short axis at each station. A higher proportion of bronchoscopists who have completed a dedicated fellowship program performed systematic endoscopic mediastinal staging. Few endoscopists routinely perform combined EBUS/EUS(-B) for mediastinal staging and use the combination only in selected cases. CONCLUSION: There are several areas of divergence between published guidelines and current practices reported by interventional bronchoscopists. EBUS alone is the most widely used endoscopic procedure for mediastinal staging in lung cancer, and a combined endoscopic approach is frequently omitted by the responders. A fellowship program appears to be associated with a higher rate of systematic endoscopic staging procedures.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Broncoscopia / Ultrassonografia / Pneumologistas / Mediastino Tipo de estudo: Diagnostic_studies / Guideline / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Broncoscopia / Ultrassonografia / Pneumologistas / Mediastino Tipo de estudo: Diagnostic_studies / Guideline / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article