Role of Computed Tomography and Mediastinoscopy in Preoperative Staging of Lung Carcinoma

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Abstract
Patients with bronchogenic carcinoma (153) were evaluated prospectively by CT [computed tomography] and mediastinoscopy. Nodes larger than 5 mm were considered potentially metastatic. Results were correlated with surgical findings. CT is more sensitive (89%) in the detection of mediastinal metastases than mediastinoscopy (67%). CT has a poor predictive value (47%); however, a negative examination is highly accurate (89%). Within a group of 100 node sites, 72% of the nodes involved by tumor were larger than 1 cm in diameter. Squamous cell carcinoma and adenocarcinoma have the highest percentage of sensitivity by CT. The very low incidence of metaststic involvement in nodes under 5 mm allows one to forego mediastinoscopy in the presence of a negative CT.