Incidence of SCLN Metastasis in Patients Referred for EBUS-TBNA
| Status: | Withdrawn |
|---|---|
| Conditions: | Lung Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 20 - 90 |
| Updated: | 2/3/2018 |
| Start Date: | May 1, 2017 |
| End Date: | July 1, 2018 |
Incidence of Supraclavicular Lymph Node Metastasis in Patients Referred for EBUS-TBNA for Presumed Primary Lung Cancer by Interventional Pulmonologists.
Evaluation of the anatomic extent of a primary lung cancer and presence of metastasis are
essential for selection of an appropriate management strategy. Endobronchial ultrasound
transbronchial needle aspiration (EBUS-TBNA) is a reliable and established technique to
evaluate involvement of mediastinal lymph nodes (LN); however, it is an invasive procedure
and may not be tolerated in patients with severe underlying lung disease. One exception is
the superficially located supraclavicular lymph nodes (SCLN), which can easily be biopsied
with percutaneous US-guided-fine needle aspiration (US-FNA). Traditionally, this nodal group
is evaluated by palpation; however, literature suggests that palpation itself fails to
capture 66% of proven disease by cytology, which challenges the acceptance that non-palpable
nodes are indicative of absent disease. Since all palpable SCLN are biopsied to rule out
metastasis, we may potentially up-stage more patients using ultrasound evaluation for
non-palpable nodes; and offer more appropriate management. Currently, the incidence for
non-palpable SCLN metastasis has not been defined in this patient population presenting for
EBUS-TBNA. The primary objective is to determine the incidence of supraclavicular lymph node
metastasis by ultrasound evaluation in patients referred for EBUS-TBNA.
essential for selection of an appropriate management strategy. Endobronchial ultrasound
transbronchial needle aspiration (EBUS-TBNA) is a reliable and established technique to
evaluate involvement of mediastinal lymph nodes (LN); however, it is an invasive procedure
and may not be tolerated in patients with severe underlying lung disease. One exception is
the superficially located supraclavicular lymph nodes (SCLN), which can easily be biopsied
with percutaneous US-guided-fine needle aspiration (US-FNA). Traditionally, this nodal group
is evaluated by palpation; however, literature suggests that palpation itself fails to
capture 66% of proven disease by cytology, which challenges the acceptance that non-palpable
nodes are indicative of absent disease. Since all palpable SCLN are biopsied to rule out
metastasis, we may potentially up-stage more patients using ultrasound evaluation for
non-palpable nodes; and offer more appropriate management. Currently, the incidence for
non-palpable SCLN metastasis has not been defined in this patient population presenting for
EBUS-TBNA. The primary objective is to determine the incidence of supraclavicular lymph node
metastasis by ultrasound evaluation in patients referred for EBUS-TBNA.
Inclusion Criteria:
- All patients age 20yrs or greater referred for EBUS-TBNA with suspicion for primary
lung cancer
Exclusion Criteria:
1. Refusal to sign consent
2. Signs of skin infection along the neck
3. Adults who lack the capacity to sign consent.
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