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Non-small Cell Lung Cancer Staging Techniques and Endoscopic Ultrasound^*

Tissue Is Still the Issue

^* From the Department of Medicine (Dr. LeBlanc), Indiana University, Indianapolis, IN; and Departments of Medicine (Dr. Ergun) and Surgery (Dr. Espada), Baylor College of Medicine, Houston, TX.

Correspondence to: Julia Kim LeBlanc, MD, Assistant Professor of Medicine, Indiana University, 550 N. University Blvd, UH 4100, Indianapolis, IN 46202

Non-small cell lung cancer (NSCLC) in the United States will continue to be a major public health issue, particularly as our elderly population grows. As surgery offers the best hope of cure for NSCLC, staging of NSCLC is critical because it directly impacts on the management of lung cancer. Cost, quality of life, safety, and accuracy of various staging methods all influence the clinical outcome. Staging of NSCLC is evolving due to the emergence of new and improved technologies. The objective of this article is to review the current methods used in staging of NSCLC. Currently, positron emission tomography and endoscopic ultrasound (EUS) show promise in identifying patients that may benefit from surgery. Histologic confirmation via EUS-guided fine-needle aspiration, however, may still be necessary to accurately stage the mediastinum.

Key Words: endoscopic ultrasound • mediastinal lymph nodes • mediastinoscopy • non-small cell lung cancer • staging • thoracotomy

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