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. 2020 Oct 23;46(6):e20190221.
doi: 10.36416/1806-3756/e20190221. eCollection 2020.

EBUS-TBNA versus surgical mediastinoscopy for mediastinal lymph node staging in potentially operable non-small cell lung cancer: a systematic review and meta-analysis

[Article in English, Portuguese]
Viviane Rossi Figueiredo  1   2 , Paulo Francisco Guerreiro Cardoso  3 , Marcia Jacomelli  2 , Lilia Maia Santos  4 , Mauricio Minata  5 , Ricardo Mingarini Terra  1   3
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Free article

EBUS-TBNA versus surgical mediastinoscopy for mediastinal lymph node staging in potentially operable non-small cell lung cancer: a systematic review and meta-analysis

[Article in English, Portuguese]
Viviane Rossi Figueiredo et al. J Bras Pneumol. .
Free article

Erratum in

  • ERRATUM.
    [No authors listed] [No authors listed] J Bras Pneumol. 2021 Feb 8;47(1):e20190221errata. doi: 10.36416/1806-3713/e20190221errata. J Bras Pneumol. 2021. PMID: 33567066 Free PMC article.

Abstract

Objective: Lung cancer (LC) is one of the leading causes of death worldwide. Accurate mediastinal staging is mandatory in order to assess prognosis and to select patients for surgical treatment. EBUS-TBNA is a minimally invasive procedure that allows sampling of mediastinal lymph nodes (LNs). Some studies have suggested that EBUS-TBNA is preferable to surgical mediastinoscopy for mediastinal staging of LC. The objective of this systematic review and meta-analysis was to compare EBUS-TBNA and mediastinoscopy in terms of their effectiveness for mediastinal LN staging in potentially operable non-small cell lung cancer (NSCLC).

Methods: This was a systematic review and meta-analysis, in which we searched various databases. We included studies comparing the accuracy of EBUS-TBNA with that of mediastinoscopy for mediastinal LN staging in patients with NSCLC. In the meta-analysis, we calculated sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios. We also analyzed the risk difference for the reported complications associated with each procedure.

Results: The search identified 4,201 articles, 5 of which (with a combined total of 532 patients) were selected for inclusion in the meta-analysis. There were no statistically significant differences between EBUS-TBNA and mediastinoscopy in terms of the sensitivity (81% vs. 75%), specificity (100% for both), positive likelihood ratio (101.03 vs. 95.70), or negative likelihood ratio (0.21 vs. 0.23). The area under the summary ROC curve was 0.9881 and 0.9895 for EBUS-TBNA and mediastinoscopy, respectively. Although the number of complications was higher for mediastinoscopy, the difference was not significant (risk difference: -0.03; 95% CI: -0.07 to 0.01; I2 = 76%).

Conclusions: EBUS-TBNA and mediastinoscopy produced similar results for mediastinal staging of NSCLC. EBUS-TBNA can be the procedure of first choice for LN staging in patients with NSCLC.

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