Non small cell lung cancer other diagnostic studies: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Furqan M Muhammad (talk | contribs)
nocaptcha
5,074 edits
Furqan M Muhammad (talk | contribs)
nocaptcha
5,074 edits
No edit summary
Line 5: Line 5:
==Overview==
==Overview==


Other diagnostic modalities for non-small cell lung cancer include thoracotomy, thoracoscopy, bronchoscopy, mediastinoscopy, transthoracic percutaneous [[fine needle aspiration]], and sputum cytology.
Other diagnostic modalities for non-small cell lung cancer include [[thoracotomy]], [[thoracoscopy]], [[bronchoscopy]], [[mediastinoscopy]], transthoracic percutaneous [[fine needle aspiration]], and sputum [[cytology]].


==Other Diagnostic Studies==
==Other Diagnostic Studies==


Other diagnostic studies may help in the staging of non-small cell cancer. Otehr diagnostic studies for non-small cell lung cancer include:<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>
Other diagnostic studies may help in the staging of non-small cell cancer. Otehr diagnostic studies for non-small cell lung cancer include:<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>
:*Thoracotomy
:*[[Thoracotomy]]
:*Thoracoscopy
:*[[Thoracoscopy]]
:*Bronchoscopy
:*[[Bronchoscopy]]
::*Bronchoscopic specimens, include:
::*Bronchoscopic specimens, include:
::*Bronchial brush
::*Bronchial brush
::*Bronchial wash
::*Bronchial wash
::*Bronchioloalveolar lavage
::*[[Bronchoalveolar lavage|Bronchioloalveolar lavage]]
::*Transbronchial fine-needle aspiration (FNA)
::*Transbronchial fine-needle aspiration (FNA)
::*Core biopsy
::*Core biopsy
:*Mediastinoscopy
:*[[Mediastinoscopy]]
::*Chamberlain procedure  
::*Chamberlain procedure  
::*Left parasternal mediastinotomy  
::*Left parasternal mediastinotomy  
::*Anterior mediastinotomy  
::*Anterior mediastinotomy  
:*Transthoracic percutaneous [[fine needle aspiration]]
:*Transthoracic percutaneous [[fine needle aspiration]]
:*Sputum cytology   
:*Sputum [[cytology]]  
::*The sensitivity or sputum cytology varies by location of the lung cancer  
::*The sensitivity or sputum [[cytology]] varies by location of the lung cancer  


The table below summarizes the advantages and limitations of different types of diagnostic modalities in non-small cell lung cancer arranged from the most to the least invasive.<ref> name="AJCC4-L">AJCC Cancer Staging Manual 4th edition; Chapter 19; Lung - original pages 115-122</ref><ref>{{cite web |url=http://www.cancerstaging.org/products/csmanual4ed.pdf |title=Archived copy |accessdate=2011-05-23 |deadurl=yes |archiveurl=https://web.archive.org/web/20110928055151/http://www.cancerstaging.org/products/csmanual4ed.pdf |archivedate=2011-09-28 |df= }}</ref><ref name="AJCC4-L">AJCC Cancer Staging Manual 4th edition; Chapter 19; Lung - original pages 115-122
The table below summarizes the advantages and limitations of different types of diagnostic modalities in non-small cell lung cancer arranged from the most to the least invasive.<ref>name="AJCC4-L">AJCC Cancer Staging Manual 4th edition; Chapter 19; Lung - original pages 115-122</ref><ref>{{cite web |url=http://www.cancerstaging.org/products/csmanual4ed.pdf |title=Archived copy |accessdate=2011-05-23 |deadurl=yes |archiveurl=https://web.archive.org/web/20110928055151/http://www.cancerstaging.org/products/csmanual4ed.pdf |archivedate=2011-09-28 |df= }}</ref><ref name="AJCC4-L">AJCC Cancer Staging Manual 4th edition; Chapter 19; Lung - original pages 115-122
{{cite web |url=http://www.cancerstaging.org/products/csmanual4ed.pdf |title=Archived copy |accessdate=2011-05-23 |deadurl=yes |archiveurl=https://web.archive.org/web/20110928055151/http://www.cancerstaging.org/products/csmanual4ed.pdf |archivedate=2011-09-28 |df= }}</ref><ref name="pmid4000199">{{cite journal |vauthors=Feinstein AR, Sosin DM, Wells CK |title=The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer |journal=N. Engl. J. Med. |volume=312 |issue=25 |pages=1604–8 |date=June 1985 |pmid=4000199|doi=10.1056/NEJM198506203122504|url=}}</ref><ref name="pmid18663166">{{cite journal |vauthors=Chee KG, Nguyen DV, Brown M, Gandara DR, Wun T, Lara PN |title=Positron emission tomography and improved survival in patients with lung cancer: the Will Rogers phenomenon revisited |journal=Arch. Intern. Med. |volume=168 |issue=14 |pages=1541–9|date=July 2008|pmid=18663166 |doi=10.1001/archinte.168.14.1541 |url=}}</ref><ref>{{cite book | last =Mountain | first =Clifton F |authorlink = |author2=Herman I Libshitz |author3=Kay E Hermes  | title =A Handbook for Staging, Imaging, and Lymph Node Classification |publisher =Charles P Young Company | location = | pages = | url =http://www.ctsnet.org/book/mountain/index.html | doi = |id =  }}</ref><ref name="pmid9187198">{{cite journal |author=Mountain CF |title=Revisions in the International System for Staging Lung Cancer |journal=Chest |volume=111 |issue=6 |pages=1710–7 |date=June 1997 |pmid=9187198 |doi=10.1378/chest.111.6.1710 |url=http://www.chestjournal.org/cgi/reprint/111/6/1710 |archive-url=https://web.archive.org/web/20030905122713/http://www.chestjournal.org/cgi/reprint/111/6/1710 |dead-url=yes |archive-date=2003-09-05 }}</ref><ref name="pmid17296659">{{cite journal |vauthors=Micames CG, McCrory DC, Pavey DA, Jowell PS, Gress FG |title=Endoscopic ultrasound-guided fine-needle aspiration for non-small cell lung cancer staging: A systematic review and metaanalysis |journal=Chest |volume=131 |issue=2 |pages=539–48|date=February 2007 |pmid=17296659|doi=10.1378/chest.06-1437|url=http://www.chestjournal.org/cgi/content/full/131/2/539}}</ref><ref name="pmid17296659">{{cite journal |vauthors=Micames CG, McCrory DC, Pavey DA, Jowell PS, Gress FG |title=Endoscopic ultrasound-guided fine-needle aspiration for non-small cell lung cancer staging: A systematic review and metaanalysis |journal=Chest |volume=131 |issue=2 |pages=539–48 |date=February 2007 |pmid=17296659 |doi=10.1378/chest.06-1437 |url=}}</ref>
{{cite web |url=http://www.cancerstaging.org/products/csmanual4ed.pdf |title=Archived copy |accessdate=2011-05-23 |deadurl=yes |archiveurl=https://web.archive.org/web/20110928055151/http://www.cancerstaging.org/products/csmanual4ed.pdf |archivedate=2011-09-28 |df= }}</ref><ref name="pmid4000199">{{cite journal |vauthors=Feinstein AR, Sosin DM, Wells CK |title=The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer |journal=N. Engl. J. Med. |volume=312 |issue=25 |pages=1604–8 |date=June 1985 |pmid=4000199|doi=10.1056/NEJM198506203122504|url=}}</ref><ref name="pmid18663166">{{cite journal |vauthors=Chee KG, Nguyen DV, Brown M, Gandara DR, Wun T, Lara PN |title=Positron emission tomography and improved survival in patients with lung cancer: the Will Rogers phenomenon revisited |journal=Arch. Intern. Med. |volume=168 |issue=14 |pages=1541–9|date=July 2008|pmid=18663166 |doi=10.1001/archinte.168.14.1541 |url=}}</ref><ref>{{cite book | last =Mountain | first =Clifton F |authorlink = |author2=Herman I Libshitz |author3=Kay E Hermes  | title =A Handbook for Staging, Imaging, and Lymph Node Classification |publisher =Charles P Young Company | location = | pages = | url =http://www.ctsnet.org/book/mountain/index.html | doi = |id =  }}</ref><ref name="pmid9187198">{{cite journal |author=Mountain CF |title=Revisions in the International System for Staging Lung Cancer |journal=Chest |volume=111 |issue=6 |pages=1710–7 |date=June 1997 |pmid=9187198 |doi=10.1378/chest.111.6.1710 |url=http://www.chestjournal.org/cgi/reprint/111/6/1710 |archive-url=https://web.archive.org/web/20030905122713/http://www.chestjournal.org/cgi/reprint/111/6/1710 |dead-url=yes |archive-date=2003-09-05 }}</ref><ref name="pmid17296659">{{cite journal |vauthors=Micames CG, McCrory DC, Pavey DA, Jowell PS, Gress FG |title=Endoscopic ultrasound-guided fine-needle aspiration for non-small cell lung cancer staging: A systematic review and metaanalysis |journal=Chest |volume=131 |issue=2 |pages=539–48|date=February 2007 |pmid=17296659|doi=10.1378/chest.06-1437|url=http://www.chestjournal.org/cgi/content/full/131/2/539}}</ref><ref name="pmid17296659">{{cite journal |vauthors=Micames CG, McCrory DC, Pavey DA, Jowell PS, Gress FG |title=Endoscopic ultrasound-guided fine-needle aspiration for non-small cell lung cancer staging: A systematic review and metaanalysis |journal=Chest |volume=131 |issue=2 |pages=539–48 |date=February 2007 |pmid=17296659 |doi=10.1378/chest.06-1437 |url=}}</ref>


{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center"
|valign=top|
| valign="top" |
|+
|+
|-
|-
Line 38: Line 38:
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Limitations}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Limitations}}
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Thoracotomy]]  
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | [[Thoracotomy]]  
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Allows the most thorough inspection and sampling of lymph node stations
*Allows the most thorough inspection and sampling of lymph node stations
*May be followed by resection of tumor, if feasible
*May be followed by resection of tumor, if feasible
|style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |
*Invasive approach
*Invasive approach
*Not indicated for staging alone
*Not indicated for staging alone
*Significant risk of procedure-related morbidity
*Significant risk of procedure-related morbidity
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Left parasternal mediastinotomy  
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Left parasternal mediastinotomy  
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Allows evaluation of the aortopulmonary window lymph nodes
*Allows evaluation of the aortopulmonary window lymph nodes
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*More invasive
*More invasive
*False-negative rate approximately 10%
*False-negative rate approximately 10%
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Chamberlain procedure  
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Chamberlain procedure  
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Access to station 5 ([[aortopulmonary window]] lymph node)
*Access to station 5 ([[aortopulmonary window]] lymph node)
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Limited applications, invasive
*Limited applications, invasive
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Mediastinoscopy|Cervical mediastinoscopy]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | [[Mediastinoscopy|Cervical mediastinoscopy]]
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Considered the gold standard (usual comparitor)
*Considered the gold standard (usual comparitor)
*Excellent for 2RL 4RL
*Excellent for 2RL 4RL
|style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |
*Invasive
*Invasive
*Does not cover all mediastinal lymph node stations; particularly subcarinal lymph nodes (station 7), paraesophageal and pulmonary ligament lymph nodes (stations 8 and 9).
*Does not cover all mediastinal lymph node stations; particularly subcarinal lymph nodes (station 7), paraesophageal and pulmonary ligament lymph nodes (stations 8 and 9).
*False-negative rate approximately 20%
*False-negative rate approximately 20%
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Thoracoscopy|Video-assisted thoracoscopy]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | [[Thoracoscopy|Video-assisted thoracoscopy]]
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Useful for the evaluation of inferior mediastinum, station 5 and 6 lymph nodes
*Useful for the evaluation of inferior mediastinum, station 5 and 6 lymph nodes
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Invasive
*Invasive
*Does not cover superior anterior mediastinum
*Does not cover superior anterior mediastinum
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Transthoracic percutaneous [[fine needle aspiration]] under CT guidance
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | Transthoracic percutaneous [[fine needle aspiration]] under CT guidance
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Widely available than some other methods
*Widely available than some other methods
|style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |
*Traverses a lot of lung tissue
*Traverses a lot of lung tissue
*High pneumothorax risk
*High pneumothorax risk
*Some lymph node stations inaccessible
*Some lymph node stations inaccessible
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Bronchoscopy]] with blind transbronchial Wang needle
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | [[Bronchoscopy]] with blind transbronchial Wang needle
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Less invasive than above methods
*Less invasive than above methods
|style="padding: 5px 5px; background: #F5F5F5;"|  
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Relatively low yield
*Relatively low yield
*Not widely practiced
*Not widely practiced
Line 96: Line 96:
==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Types of cancer]]
[[Category:Types of cancer]]

Revision as of 23:15, 23 February 2018

Non Small Cell Lung Cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Non Small Cell Lung Cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray

CT Scan

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Management Approach

Stage I
Stage II
Stage III
Stage IV
Metastatic Cancer

Medical Therapy

Chemotherapy
Radiation Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Non small cell lung cancer other diagnostic studies On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Non small cell lung cancer other diagnostic studies

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Non small cell lung cancer other diagnostic studies

CDC on Non small cell lung cancer other diagnostic studies

Non small cell lung cancer other diagnostic studies in the news

Blogs on Non small cell lung cancer other diagnostic studies

Directions to Hospitals Treating Non small cell carcinoma of the lung

Risk calculators and risk factors for Non small cell lung cancer other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Other diagnostic modalities for non-small cell lung cancer include thoracotomy, thoracoscopy, bronchoscopy, mediastinoscopy, transthoracic percutaneous fine needle aspiration, and sputum cytology.

Other Diagnostic Studies

Other diagnostic studies may help in the staging of non-small cell cancer. Otehr diagnostic studies for non-small cell lung cancer include:[1]

  • Bronchoscopic specimens, include:
  • Bronchial brush
  • Bronchial wash
  • Bronchioloalveolar lavage
  • Transbronchial fine-needle aspiration (FNA)
  • Core biopsy
  • Chamberlain procedure
  • Left parasternal mediastinotomy
  • Anterior mediastinotomy
  • The sensitivity or sputum cytology varies by location of the lung cancer

The table below summarizes the advantages and limitations of different types of diagnostic modalities in non-small cell lung cancer arranged from the most to the least invasive.[2][3][4][5][6][7][8][9][9]

Procedure Advantages Limitations
Thoracotomy
  • Allows the most thorough inspection and sampling of lymph node stations
  • May be followed by resection of tumor, if feasible
  • Invasive approach
  • Not indicated for staging alone
  • Significant risk of procedure-related morbidity
Left parasternal mediastinotomy
  • Allows evaluation of the aortopulmonary window lymph nodes
  • More invasive
  • False-negative rate approximately 10%
Chamberlain procedure
  • Limited applications, invasive
Cervical mediastinoscopy
  • Considered the gold standard (usual comparitor)
  • Excellent for 2RL 4RL
  • Invasive
  • Does not cover all mediastinal lymph node stations; particularly subcarinal lymph nodes (station 7), paraesophageal and pulmonary ligament lymph nodes (stations 8 and 9).
  • False-negative rate approximately 20%
Video-assisted thoracoscopy
  • Useful for the evaluation of inferior mediastinum, station 5 and 6 lymph nodes
  • Invasive
  • Does not cover superior anterior mediastinum
Transthoracic percutaneous fine needle aspiration under CT guidance
  • Widely available than some other methods
  • Traverses a lot of lung tissue
  • High pneumothorax risk
  • Some lymph node stations inaccessible
Bronchoscopy with blind transbronchial Wang needle
  • Less invasive than above methods
  • Relatively low yield
  • Not widely practiced
  • Bleeding risk

References

  1. ↑ Kinsey CM, Arenberg DA (2014). "Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging". Am. J. Respir. Crit. Care Med. 189 (6): 640–9. doi:10.1164/rccm.201311-2007CI. PMID 24484269.
  2. ↑ name="AJCC4-L">AJCC Cancer Staging Manual 4th edition; Chapter 19; Lung - original pages 115-122
  3. ↑ "Archived copy" (PDF). Archived from the original (PDF) on 2011-09-28. Retrieved 2011-05-23.
  4. ↑ AJCC Cancer Staging Manual 4th edition; Chapter 19; Lung - original pages 115-122 "Archived copy" (PDF). Archived from the original (PDF) on 2011-09-28. Retrieved 2011-05-23.
  5. ↑ Feinstein AR, Sosin DM, Wells CK (June 1985). "The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer". N. Engl. J. Med. 312 (25): 1604–8. doi:10.1056/NEJM198506203122504. PMID 4000199.
  6. ↑ Chee KG, Nguyen DV, Brown M, Gandara DR, Wun T, Lara PN (July 2008). "Positron emission tomography and improved survival in patients with lung cancer: the Will Rogers phenomenon revisited". Arch. Intern. Med. 168 (14): 1541–9. doi:10.1001/archinte.168.14.1541. PMID 18663166.
  7. ↑ Mountain, Clifton F; Herman I Libshitz; Kay E Hermes. A Handbook for Staging, Imaging, and Lymph Node Classification. Charles P Young Company.
  8. ↑ Mountain CF (June 1997). "Revisions in the International System for Staging Lung Cancer". Chest. 111 (6): 1710–7. doi:10.1378/chest.111.6.1710. PMID 9187198. Archived from the original on 2003-09-05.
  9. ↑ 9.0 9.1 Micames CG, McCrory DC, Pavey DA, Jowell PS, Gress FG (February 2007). "Endoscopic ultrasound-guided fine-needle aspiration for non-small cell lung cancer staging: A systematic review and metaanalysis". Chest. 131 (2): 539–48. doi:10.1378/chest.06-1437. PMID 17296659.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Non_small_cell_lung_cancer_other_diagnostic_studies&oldid=1448228"