Possibilities of invasive N-staging methods in the assessment of non-small cell lung cancer

Abstract

Accurate mediastinal staging of non-small cell lung cancer is an important aspect of preoperative examination of the patient and largely determines the further treatment strategy and prognosis of the disease. The possibilities of non-invasive staging using computed tomography and positron emission tomography are limited. This review presents modern methods of invasive N-staging procedures in NSCLC treatment used in the world practice. The advantages and disadvantages of fine-needle aspiration biopsy of mediastinal lymph nodes under the control of endosonography, videomediastinoscopy - a simple and affordable way to study regional lymph nodes, which has gained fame as the «gold standard» for many years of application. Emphasis is placed on methods of transcervical mediastinal lymphadenectomy (VAMLA and TEMLA), which demonstrated a number of advantages compared to videomediastinoscopy in lung cancer surgery. The analysis of the parameters of diagnostic efficiency and «weak points» of each method is devoted to the literature review, which will allow the doctor to choose the right approach to determining the N-stage in a particular cli­nical situation.