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The Value Of Chest Computer Tomography And Cervical Mediastinoscopy In The Preoperative Assessment Of Patients With Malignant Pleural Mesothelioma.

J. H. Schouwink, L. Kool, E. Rutgers, F. Zoetmulder, N. van Zandwijk, Marc J v d Vijver, P. Baas
Published 2003 · Medicine

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BACKGROUND Patients with localized malignant pleural mesothelioma (MPM) can be considered for surgical resection with or without additional treatment. For this approach it is imperative to select patients without mediastinal lymph node involvement. In this study cervical mediastinoscopy (CM) is compared with computer tomography (CT) scanning for its diagnostic accuracy in assessing mediastinal lymph nodes during preoperative workup. METHODS Computer tomography scans of the chest and CM were performed in 43 patients with proven unilateral MPM. The CT scans were reviewed by one radiologist and two chest physicians. At CM the lymph node samples were taken from stations Naruke 2, 3, 4, and 7. Computer tomography and CM results were compared with final histopathologic findings obtained at thoracotomy or, if this was not performed, at CM. RESULTS Computer tomography scanning revealed pathologic enlarged lymph nodes with a shortest diameter of at least 10 mm in 17 of 43 patients (39%). There was histopathologic evidence of lymph node metastases at CM in 11 of these patients (26%). This resulted in a sensitivity of 60% and 80%, a specificity of 71% and 100%, and a diagnostic accuracy of 67% and 93% for CT and CM, respectively. CONCLUSIONS Cervical mediastinoscopy is a valuable diagnostic procedure for patients with MPM who are considered candidates for surgical-based therapy. Results of CM are more reliable than those obtained by CT scanning. Our data confirm results of previous studies reporting that mediastinal lymph node involvement is a frequent event in MPM.
This paper references
10.1183/09031936.97.10071547
Prospective evaluation of computed tomography and mediastinoscopy in mediastinal lymph node staging.
A. Gdeedo (1997)
10.1097/00000658-199609000-00005
Extrapleural pneumonectomy in the multimodality therapy of malignant pleural mesothelioma. Results in 120 consecutive patients.
D. Sugarbaker (1996)
10.1016/S0169-5002(98)00083-X
The clinical importance of magnetic resonance imaging versus computed tomography in malignant pleural mesothelioma.
A. Knuuttila (1998)
10.1378/CHEST.113.3.723
Factors predictive of survival among 337 patients with mesothelioma treated between 1984 and 1994 by the Cancer and Leukemia Group B.
J. Herndon (1998)
10.1378/CHEST.120.4.1167
Intraoperative photodynamic therapy after pleuropneumonectomy in patients with malignant pleural mesothelioma: dose finding and toxicity results.
H. Schouwink (2001)
10.2214/AJR.172.4.10587144
Staging of malignant pleural mesothelioma: comparison of CT and MR imaging.
R. Heelan (1999)
10.1200/JCO.1994.12.6.1156
A phase II trial of pleurectomy/decortication followed by intrapleural and systemic chemotherapy for malignant pleural mesothelioma.
V. Rusch (1994)
10.1200/JCO.1998.16.1.145
Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience.
D. Curran (1998)
10.1016/S0003-4975(99)01038-3
Important prognostic factors in patients with malignant pleural mesothelioma, managed surgically.
V. Rusch (1999)
10.1016/S0003-4975(98)00799-1
Operation and photodynamic therapy for pleural mesothelioma: 6-year follow-up.
T. L. Moskal (1998)
10.1148/RADIOLOGY.213.2.R99NV46530
Metastases from non-small cell lung cancer: mediastinal staging in the 1990s--meta-analytic comparison of PET and CT.
B. Dwamena (1999)
10.1007/978-1-4615-1589-0_13
Malignant pleural mesothelioma.
L. Ho (2001)
10.1056/NEJM200007273430404
Preoperative staging of non-small-cell lung cancer with positron-emission tomography.
R. Pieterman (2000)
10.2214/AJR.159.5.1414807
Malignant pleural mesothelioma: value of CT and MR imaging in predicting resectability.
E. Patz (1992)
10.1038/bjc.1997.468
Photodynamic therapy as adjuvant therapy in surgically treated pleural malignancies.
P. Baas (1997)
10.1016/S0003-4975(96)01228-3
Patterns of failure after trimodality therapy for malignant pleural mesothelioma.
E. Baldini (1997)
10.1016/0002-9149(75)90916-9
Predictive value of laboratory tests
R. Galen (1975)
10.1164/AJRCCM/141.5_PT_1.1096
Computed tomography to stage lung cancer. Approaching a controversy using meta-analysis.
R. Dales (1990)
10.7326/0003-4819-127-8_Part_1-199710150-00004
Endoscopic Ultrasonography, Fine-Needle Aspiration Biopsy Guided by Endoscopic Ultrasonography, and Computed Tomography in the Preoperative Staging of Non-Small-Cell Lung Cancer: A Comparison Study
F. Gress (1997)
10.1200/JCO.1993.11.6.1172
Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma.
D. Sugarbaker (1993)
10.1016/S0022-5223(19)39559-5
Lymph node mapping and curability at various levels of metastasis in resected lung cancer.
T. Naruke (1978)
10.1378/CHEST.113.1_SUPPLEMENT.66S
A review of chemotherapy trials for malignant mesothelioma.
C. Ryan (1998)
10.1378/CHEST.116.SUPPL_3.450S
Pleuropneumonectomy in the treatment of malignant pleural mesothelioma.
S. Grondin (1999)
10.1378/CHEST.114.3.713
Metabolic imaging of malignant pleural mesothelioma with fluorodeoxyglucose positron emission tomography.
F. Bénard (1998)
10.1016/S0022-5223(99)70469-1
Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients.
D. Sugarbaker (1999)
10.1148/RADIOLOGY.219.1.R01AP44252
Evaluation of mediastinal lymphadenopathy with endoscopic US-guided fine-needle aspiration biopsy.
M. Wiersema (2001)
10.1016/S0003-4975(10)60855-7
Clinical staging and the tendency of malignant pleural mesotheliomas to remain localized.
R. Nauta (1982)



This paper is referenced by
10.1017/9781316402009.004
Multi-modality Imaging of Pleural and Peritoneal Disease
J. Cunningham (2018)
10.1016/J.CRAD.2005.05.015
Use of imaging in the management of malignant pleural mesothelioma.
R. Benamore (2005)
10.1007/s11604-016-0555-1
Present and future roles of FDG-PET/CT imaging in the management of malignant pleural mesothelioma
K. Kitajima (2016)
10.1148/rg.346130089
Multimodality imaging for characterization, classification, and staging of malignant pleural mesothelioma.
Larry T Nickell (2014)
10.1016/J.LUNGCAN.2005.03.008
Malignant pleural mesothelioma: staging systems.
P. V. Schil (2005)
10.1007/s11912-011-0177-9
Malignant Pleural Mesothelioma
S. Raja (2011)
10.1158/1078-0432.CCR-07-5283
Transesophageal Endoscopic Ultrasound with Fine Needle Aspiration in the Preoperative Staging of Malignant Pleural Mesothelioma
K. Tournoy (2008)
10.1007/0-387-31056-8_38
Therapy for malignant pleural mesothelioma
H. Pass (2006)
10.1007/978-1-84996-492-0_47
Malignant Pleural Mesothelioma: Patient Selection for Pleurectomy
R. Flores (2011)
10.1111/j.1759-7714.2012.00127.x
Clinical and biologic prognostic factors in malignant pleural mesothelioma
V. Ambrogi (2012)
10.3978/j.issn.2225-319X.2012.10.01
Radical surgery for malignant pleural mesothelioma: have we identified the appropriate selection tools?
N. van Zandwijk (2012)
10.1634/THEONCOLOGIST.12-7-850
Multidisciplinary treatment of malignant pleural mesothelioma.
G. Ceresoli (2007)
10.1097/RMR.0000000000000162
MR Imaging of Pleural Neoplasms.
B. Carter (2018)
10.1016/J.CGH.2006.11.013
Multispectral imaging autofluorescence microscopy in colonic and gastric cancer metastatic lymph nodes.
D. Pantalone (2007)
10.1002/cncr.24886
Proposed adjustments to pathologic staging of epithelial malignant pleural mesothelioma based on analysis of 354 cases
W. Richards (2010)
10.1007/978-3-642-10862-4_7
Surgical therapy of mesothelioma.
D. Rice (2011)
10.21037/shc.2018.09.02
What are the implications of the revised N staging system for surgery
Hasan Fevzi Batırel (2018)
10.1510/icvts.2009.213611
Staging algorithm for diffuse malignant pleural mesothelioma.
M. Zieliński (2010)
10.1200/JCO.2004.10.071
Neoadjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma.
W. Weder (2004)
10.1016/j.cllc.2017.01.008
The Controlling Nutritional Status Score Is a Significant Independent Predictor of Poor Prognosis in Patients With Malignant Pleural Mesothelioma
Shinkichi Takamori (2017)
10.1097/00005382-200605000-00006
Preoperative Evaluation of Patients With Malignant Pleural Mesothelioma: Role of Integrated CT-PET Imaging
M. Truong (2006)
10.13032/TJOP.2052-5931.100120
The Role of Surgery in Malignant Pleural Mesothelioma
Levon Toufektzian (2015)
mpact of lymph node metastasis on outcome after xtrapleural pneumonectomy for malignant pleural esothelioma arc
de Perrot (2006)
10.1016/S0761-8425(06)71782-X
2.1 Quels critres diagnostiques pour le msothliome pleural malin (MPM)
P. Astoul (2006)
10.1016/j.athoracsur.2008.04.012
Prevalence and pattern of lymph node metastasis in malignant pleural mesothelioma.
A. Abdel Rahman (2008)
10.1016/J.JTCVS.2006.06.044
Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma.
M. D. de Perrot (2007)
10.1007/978-3-030-27233-3_8
Primary Tumors of the Pleura
R. Ledda (2020)
Mesothelioma Prevalence and Pattern of Lymph Node Metastasis in Malignant Pleural
Eman G. Farahat (2013)
10.1016/J.RO.2004.04.005
Imaging evaluation in the diagnosis and staging of malignant pleural mesothelioma.
M. Truong (2004)
10.1016/j.ejcts.2010.08.028
Staging malignant pleural mesothelioma: additional investigation may not improve accuracy.
D. West (2011)
10.1016/J.EJCTS.2003.12.001
The case for routine cervical mediastinoscopy prior to radical surgery for malignant pleural mesothelioma.
J. Pilling (2004)
10.1016/j.lungcan.2018.01.001
Computed tomography in the evaluation of malignant pleural mesothelioma-Association of tumor size to a sarcomatoid histology, a more advanced TNM stage and poor survival.
Juuso Paajanen (2018)
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