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ORIgINAL ARTICLE Nodal Staging in Lung Cancer A Risk Stratification Model for Lymph Nodes Classified as Negative by EBUS-TBNA Matthew Evison,*† Julie Morris,‡ Julie Martin,* Rajesh Shah,§ Philip V. Barber,* Richard Booton,*† and Philip A. J. Crosbie*† 35 of 54 and 24 of 37 lymph nodes classified as high risk were proven Background: Over the last 10 years, endobronchial ultrasound- malignant. The negative predictive value of the risk stratification guided transbronchial needle aspiration (EBUS-TBNA) has become model for the derivation set and validation set was 99.3% (95% con- established as the first-line nodal staging procedure of choice for fidence interval 96.1%–99.6%) and 97.9% (95% confidence interval lung cancer patients. However, the pathway for patients following a 92%–99.6%), respectively. negative EBUS-TBNA has not been clearly defined. The primary aim Conclusion: This risk stratification model may assist lung cancer of this study was to develop and validate a risk stratification model multidisciplinary teams in deciding which patients need further stag- to categorize lymph nodes deemed negative by EBUS-TBNA into ing procedures and which may proceed directly to treatment after a “low-risk” and “high-risk” groups, where “risk” refers to the risk of negative EBUS. false negative sampling. Methods: A retrospective analysis of a prospectively maintained Key
Journal of Thoracic Oncology – Wolters Kluwer Health
Published: Jan 1, 2015
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